Voices of Medicine: Lisa Criscione-Schreiber, MD, on Having More Voices at the Table

Lisa Criscione-Schreiber, MD, MEd, is the vice chair for education in the Department of Medicine. Schreiber joined the faculty in 2003 having completed her undergraduate and medical school programs here at Duke as well as her residency and fellowship. She  co-founded the Duke Lupus Clinic in summer 2007, simultaneously becoming rheumatology associate fellowship program director, then PD in 2008. From 2011 – 2014 she was funded by the Clinician Scholar Educator career development award from the Rheumatology Research Foundation, completing her Master of Education degree to further her career as a clinician educator researcher. She was one of the founding coaches of the DOM FDA, Education Scholars Branch and served as PWIM Chair from 2017 until becoming Vice Chair for Education in summer 2020.

What led you to a career in medicine or your current position here at Duke?

At this point I can look back at my career and construct a retrospective narrative to make it seem like I was always headed towards my current position. But in reality, my career has been a meandering journey in many directions and with many twists, turns, and so many dead ends.  I do know that each of my work experiences, whether I chose them or fell into them, taught me important lessons that help me in my current work. 

I distinctly remember sitting in the 8100 workroom during attending rounds as a second year medical student, listening to Dr. Dan Sexton teach us something in that incredibly reasonable, matter-of-fact way he teaches, and thinking, ‘One day, I want to do what he’s doing right now’. I guess that was the moment I decided I would become an academic clinician educator.  As a young faculty member, I loved working with rheumatology fellows and they seemed to like working with me. The program director role seemed like a great opportunity to be a mentor and advocate during a crucial time in professional development. It also seemed like a great opportunity to affect the culture of a whole Division, since our training programs are so central to everything we do at Duke. When the opportunity to become PD became available, I jumped at it. I absolutely love being rheumatology program director. I never wanted to do or be anything else, until 2017 when I went through Duke’s Academic Leadership, Innovation, and Collaborative Engagement (ALICE) program.  

In ALICE, Dr. Ann Brown led us through an activity called “the future history of my career,” where we had to describe our career trajectory while imaging ourselves in some future leadership position. This exercise was supposed to help inform our current decisions. Through this exercise I figured out that my career had prepared me to become a vice chair for education. That was a nice realization which at the time had no outlet, so I put it in the parking lot.  In 2018, a call went out for a leader of the Program for Women in Internal Medicine (PWIM).  I had been attending PWIM events since residency and I thought this would be a great opportunity to get involved at a department level to try to help women advance their careers.  I was fortunate to be selected for the position and to get to meet frequently with Drs. Laura Svetkey, Kim Evans, Suchita Sata and Ms. Kim Dorman.  I learned so much about leadership from observing these women.  I loved my work in faculty development and diversity and it was so meaningful to be a part of what the department has been trying to move forward in promoting diversity, equity and inclusion here at Duke.  When Dr. Cooney announced the search for a vice chair for education, I thought I was ready to apply for the position. I feel very fortunate to have been given this opportunity to help support our learners and educators and to help shape the learning culture in the Department of Medicine. 

 

With regard to the gender/racial/age identity group(s) that is most relevant to you, please talk about how your personal experiences have impacted your career.

Nobody in my family had been in medicine before me, and it’s not a career I ever considered until college.  My father, who grew up with very little, offered two consistent pieces of advice throughout his life. First, he said that no matter what career I chose, as a woman he urged me to make sure I had the capability to be financially independent. Second, he encouraged me to choose whatever career I wanted and not be limited by any perceptions of what careers were “appropriate” for women. He was very proud of me becoming a physician.  He traveled a lot for his job, but my memories looking back almost always include him, because when he was home, he was engaged with our family. Whenever I worry that I work too much, I remind myself that I don’t even remember the times my father was gone, but I remember the time he spent with us growing up. That helps reassure me that my kids will remember the quality time I spend with them, and won’t remember the couple weeks a year that I travel for work, or other times when I have to work a lot.

My mother, who is brilliant and can’t sit still, left her career as a fashion designer to be a stay at home mom until my youngest sibling started first grade. If she wasn’t sewing our clothes she was gardening, or painting, or cooking, or creating incredible cakes for our birthday celebrations. That’s a hard standard to match when you’re a doctor who works full time. So when I had kids, I decided that priority #1 was to be a great mom who would give my kids great memories.  Throughout my career I have sought advice from the women such as Drs. Nancy Allen, Virginia Kraus, Diana McNeill and others who successfully navigated motherhood in times when colleagues were less accepting of mothers as physicians. I made a conscious decision to never apologize or feel guilty about the time I spend being a mother. I’ve always been completely open about the times that I left work early, or canceled clinics ahead of time, or turned down meetings or other opportunities to support my kids, hoping that one day I could be an example to other women just like so many strong women have been for me. 

I think I’m part of the “in between generation” of women.  During the course of my career, I do not feel like I was treated as less qualified than men, or less capable of becoming a leader. I do not feel that I have been overlooked for positions due to my gender.  I was certainly addressed as a nurse during my training, but can think of few examples in which patents ever questioned that I was their doctor once I clarified that for them. Just this morning I walked into Duke South in plain clothes and a man sitting on a bench said “good morning, doc.” I don’t remember any of my supervisors ever giving me the impression that I was expected to be any less capable or successful than my male colleagues.  I would say I’ve observed a progression in leadership during my career in which I’ve seen more women in leadership positions as time has progressed. 

 

With regard to your identity group(s), what are some of the strengths that you bring to your role at Duke-

I think sometimes as a woman it is expected that I will have responsibilities as a mother. I think that expectation gives me the opportunity to be very open about the importance I place on my role outside of work. I think as a woman I can help support my male colleagues who want to be involved in all their children’s important events and normalize the fact that we all have lives outside of work that are important, and being present to our family and friends outside of work is extremely important, no matter what your gender or expected societal role. 

Looking forward, how do you think the DOM is doing in its mission to become more inclusive? 

From my vantage point, the DOM has made significant progress in actions to become more inclusive. In the past, it looked like the “big” leadership positions were not open to most people in our department. Earlier in my career there did not seem to be searches for people to fill positions, they were just “filled from within” based on “who you know.” That behavior favored sameness, which generally excluded women and individuals from minority backgrounds. That has changed in the DOM and leadership positions across the department now have calls for applications and carefully thought out processes to ensure that a wide variety of individuals are considered for new roles. I also think that our development of the Civility Champions program, and our participation in Stepping in 4 Respect have helped empower people in our department to speak up when they observe harassment and to think about how our words and actions affect others, along with how important it is to make everyone feel respected and supported for their intrinsic value. I think we all recognize that teams do better when there is diversity of gender, race, opinions, and backgrounds. From my viewpoint, I think our department as a whole has embraced the concept that everything we do gets better when we include more voices in our work.  

 

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