Mentorship, Advocacy, and Work-Life Balance Are Key to Supporting Women in Oncology

Kelly E. McCann, MD, PhD

In an interview with OncLive®, Kelly E. McCann, MD, PhD, shared advice for women in oncology, highlighted the personal experiences that shaped her career, and explained the role of mentorship in professional growth.

McCann is an associate clinical professor of medicine at UCLA Medical School in Los Angeles, California. In a previous article, McCann discussed how patient care and guidance has driven her passion in oncology.

OncLive: What advice would you offer to younger women pursuing a career in oncology?

McCann: I felt unprepared about a lot of [aspects] going into this, this job. When you’re in training, you’re focusing on mostly yourself: educating yourself and getting research projects going. The biggest surprise has been how much of oncology has become a business. I don’t have [many of those business] skills, so a lot of what we learn on the fly is more related to [facets of the job] that I don’t find particularly rewarding, like administration-type work and spending weekends trying to catch up on tasks that could be done by somebody other than myself.

What role does mentorship play for someone seeking to pursue a career in oncology?

There’s a big difference between mentorship, sponsorship and coaching. Mentorship involves somebody taking you on as an apprentice. They might tell you about their career path and help you along the same type of career path. Sponsorship involves someone who is willing to recommend you for [career opportunities] because they have the connections you don’t have. For example, my current mentor is Aditya Bardia, MD MPH, FASCO, [of UCLA Health]. If he can’t give a talk or would like me to give that talk, he’ll recommend me. I get many opportunities because he is a sponsor as well as a mentor.

Coaching is also important, because a coach can be anybody. A coach is somebody who can draw out what you actually want [from your career] by asking questions and listening to the answers without trying to impress their own career path on you. All three of those [roles] are important. At the Women in Oncology brunch during the 42nd Annual Miami Breast Cancer Conference, we talked about how you need all 3 types to have a fulfilling career.

How do biases affect female oncologists’ experience in the field?

Some of the other women [at the brunch]—especially, Reshma Jagsi, MD, DPhil [of the Winship Cancer Institute of Emory University in Atlanta, Georgia]—spoke about how although biases have gotten better over time, they are still there. Misogynistic biases in particular are going by the wayside on some level; [however, although they are] definitely no longer overt, those biases still exist.

For example, when I go into a room with my fellow in the hospital, the family the patient usually assumes I am the trainee or the nurse. Then they look to the fellow, and if the fellow is male, the patient assumes that’s the person to whom they should direct their attention. It doesn’t often occur to the patient that maybe I’m the boss in the room. We are still dealing with these biases.

Another [topic] that came up [during the brunch] for women who wish to have children is that women oncologists who have children often are doing a higher level of the home care and childcare than their spouses might be doing. That’s incredibly difficult to balance when you have a career in oncology, because we have so many patients who we are responsible for [in addition to] trying to find the time to manage a family, a research career, and a patient clinical career. There’s never enough time to fulfill all those roles to the level you want. Those tradeoffs make it incredibly difficult to figure out how to manage all [the aspects of your life], especially if you’re a perfectionist and would like to be doing the best for all and you just can’t get to it all.

At [the 2024] brunch, a lot of fellows [attended], so the conversation was a bit different from this year. The attendance was different [this year] in that people from all phases of their careers attended. Around the tables, we spent a lot of time sharing our own stories. I think that's the most important [message]: there’s no one right way to do anything. It’s important to hear a bunch of different aspects and a bunch of different stories, and figure out what applies to you, what doesn’t apply to you, and what you want to do differently. Talking through those topics was incredibly valuable to me as one of the younger people sitting at the table.

Victoria Rizk, MD, [of the Cancer Center of South Florida and the Tampa General Hospital Cancer Institute] brought up imposter syndrome, which I think a lot of us have: that feeling that somehow you’re not worthy or valuable enough to be in the position that you were in or are in. [You might feel like] you’re an imposter when you deserve to be there, worked just as hard [as other people], and got to that position. I don’t know where that comes from, but I think most women I know have felt that at some point or another. On some level, it’s gratitude for being where you are, but then also feeling like you’re not worthy to be there. I think part of that comes from all the exposures [to different career aspects and challenges] that we have over all the years that chip away at our self-esteem, which is incredibly dangerous.

A concept related to imposter syndrome is superhero syndrome, where you feel the need to take on all responsibilities by yourself, including caring for all your patients. Have you encountered this in your experience?

Superhero syndrome is a great term, especially for women who are trying to balance all the aspects of their lives—the clinical aspects, the research, and their home life. I struggle with taking on so much responsibility and not being able to say no when somebody asks me to do something. I think a lot of oldest children struggle with that, because we’re the responsible ones, and we’re used to that role of trying to take care of everything and then ultimately feeling like a failure because we can’t do it all. There’s not enough time in the day to do everything to that perfect level.

I think also with patients in particular, I’ve struggled a lot with setting boundaries sometimes. I care so much about patients, and it’s difficult to try to maintain an edge of warmth that is not so warm that it verges on unprofessional. It’s difficult to say: ‘I’m going to turn off my phone for an hour and have dinner with my family instead of instead of being constantly available.’

What other challenges have you faced regarding setting boundaries to try to improve your work-life balance?

I’m still working on setting boundaries. I’m not great at it because I’m a workaholic. My work has become my whole life, so I don’t have that work-life balance that people aspire to. To set boundaries with patients, patients have to know where you’re coming from. If a patient thinks you only have 20 patients total, you can’t [tell them that you actually] have [many more] patients, and that’s why you didn’t respond to their messages immediately. There are expectations on both sides that lead to miscommunications, and that’s what makes boundary setting particularly difficult.

How has the role of networking with other oncologists evolved throughout your career?

One of the helpful aspects of this brunch was that I know some of the other people [who spoke] on the stage: Jo Chien, MD, [of the University of California San Francisco Helen Diller Comprehensive Cancer Center] and Reshma Mahtani, DO, [of Baptist Health Miami Cancer Institute in Florida]. I know their stories and a bit of their backgrounds, so I can call on them [when I’m looking for their particular insights on certain topics]. That was what made this year’s brunch particularly good. We all know each other at this point, and developing collaborations and networks is so important in oncology, all for the betterment of patient care, hopefully.