How did you get started in medicine and come to where you are today?

I’ve touched upon just about every aspect of healthcare. I’ve been in academia for four decades and an administrator for about 20 years. I’m really happy I chose this path because it gave me a lot of flexibility and opportunity to pursue my diverse interests.. In the initial stages of my career, I engaged in basic science—working in a lab, trying to understand the basic mechanisms for how fluid actually leaves the eye—which was very critical to my ultimate profession of being a glaucoma specialist. This was all rooted in my undergraduate and graduate education at MIT, trying to understand the basic mechanisms of flow of fluids. When I got started, I thought I would always be in research because that was where I was rooted and started my professional journey.

As I started becoming more involved in patient care, however, I recognized there would be great opportunities to do clinical research. As my practice became busier, it became difficult to maintain my engagement in basic science, so I shifted gears to clinical research, participating and leading clinical trials, testing new therapeutics for glaucoma, and investigating new surgical procedures. I was recruited to be an administrator at the University of Michigan as an Assistant Dean for the Faculty, and ultimately the Department Chair of Ophthalmology at University of Maryland. It was there that I became the first woman to lead a university-based ophthalmology department in the country; today, only about 16 out of 140 are women-led. Clearly, we still have a long way to go to achieve gender equity. I later became the Dean of the Morehouse School of Medicine and the Senior Vice President for Health Sciences at Howard University.

My current interests have expanded to include other aspects of equity. One of those areas of interest is related to dismantling the race-corrected algorithms that exist and trying to help all of us in the House of Medicine find alternative ways that we can consider the great diversity that we have across human populations.

This all brings me to the point where I am now, where I am mostly working in administration as the Vice Dean at the University of Pennsylvania, and I have the chance to expend energy not only leading efforts to advance inclusion, diversity, and equity at Penn Medicine, but also as an elected council member at the National Academy of Medicine. I’m also a board member of Ascension, which is the second largest private health system in the US, and I lead the quality committee. As a board member, I have enjoyed being engaged in health policy and learning how that can impact the way that medicine is practiced in a large system. I also have written on health policy in gender equity and ancestral and ethnic equity issues.

I look forward to being involved in more board opportunities and the chance to do more writing on health policy and health equity. I also enjoy mentoring and sponsoring others because I recognize I couldn’t have made it here today without active participation of many mentors and sponsors. Overall, my career has been a broad arc that all started with studying how basic mechanisms could lead to diagnostic and therapeutic breakthroughs. My career experience exemplifies how one can really start in one place and end in a different place based on your interest and opportunities.

Developing communication skills is so critical. It is so critical to approach a topic from where the individual is actually rooted in his or her understanding. As an ophthalmologist, we are only 3% of the house of medicine, so in most instances, people don’t know what we’re talking about. Even in medicine, I’ve had to translate the value of eye health and advocate for it to affirm its value as a population health priority. Understand where the audience is actually starting from and ensure that your language matches their understanding.

What were some barriers you faced as the first woman chairing a university-center ophthalmology department?

Playing golf with husband, Dr. Frank Williams.

Before I took the Department Chair position at the University of Maryland, I was reluctant at first. It was really my husband who encouraged me and said you should do this, this is an opportunity. I knew then when I took on this major role that I would have to give up something. There is an element of sacrifice in actually taking on these challenges early on; I was in my early forties, and this meant that my engagement in basic science research would have to be on “hold,” and, in truth, I never got back to it, because science moves on. I then pivoted to more clinical research. Thankfully, I have a supportive spouse who has been my greatest advocate and confidante at every stage of my journey.

As I moved up the academic ladder, there were additional opportunities to make a difference. Unless you’re in the position, you don’t realize how much influence and impact you can have by sitting in a different seat. Some of the barriers to me taking on the position were self-inflicted, as it’s about making choices. There were also systemic barriers, however; we as women are still not viewed as leaders who should be in place. For example, when I was a woman Department Chair, I always made sure to have my white coat on and sitting behind my desk to ensure that the appearance of leadership was there, even though one’s expectations would suggest that there would be a man sitting in that role. We need to change the way we think about leaders and leadership as a society and reconsider the expectations we have for what makes a good leader. We have to ensure that future women leaders have the opportunity to grow and develop their leadership skills, so that when the opportunities are there, they are ready.

How has COVID-19 impacted the professional careers of women in particular?

Seeing patients in the pandemic. Dr. Higginbotham with her scribe and mentee, Ms. Dominique Alexis.

Recently, I had the honor of chairing a committee on the impact of COVID-19 on the careers of women in academic STEMM on behalf of the National Academies of Science, Engineering, and Medicine (NASEM). Barriers which women and those who identify as women have traditionally faced have been more significantly revealed during this COVID-19 pandemic. We found that women early on in their careers, such as postdocs or junior faculty, are deciding to leave academia, and this does not bode well for the future. Women in fields like physics and computer science, where there are few women to begin with, face increased isolation during COVID; without the opportunity to go to a professional meeting and meet with a mentor or sponsor to talk about research formally with colleagues, it has been really hard. We are concerned, especially as institutional leaders, that small advances that have been made in specific fields will be rolled back now. This is not a time for institutions to stand by and just watch. This is a time to really lean in to make changes in policies and provide more supportive infrastructure to ensure everyone’s success. We don’t need to wait another 5 years to see another paper that shows that not only have we not made progress, we have turned the clock backwards.

Who are some of your most notable mentors or sponsors?

When I was at HMS, there was a woman faculty member at Mass Eye and Ear, Dr. Mathea Allansmith, whom I still connect with to this day. She was my role model as a woman in ophthalmology who not only had five kids at the time, but led her own lab and managed a busy clinical practice. That’s a sort of role model we need to see more of - women who enjoy what they are doing and having a chance to influence the careers of others.

Another individual, Dr. Morton Goldberg, who also is an HMS graduate, was my first chair at University of Illinois. He opened up my eyes to the possibilities of doing more than what I had imagined. When I first met him, he shared with me all the books his faculty members at the time had written. I knew then that writing or editing a book was not only an opportunity, but an expectation. The first book I co-edited, I did under his watch, and proved to be a great way to get my career started.

What words of wisdom do you have for students in medicine?

It’s important to know what your primary interests are. To just be self aware, to follow your passion. It does help to know what drives your passion.. Proactively seek out mentors and sponsors. Sponsors are important - these are people who are senior in their careers and expend political capital on your behalf. Make sure you can take advantage of opportunities which peak your interest, in addition to having a broad set of mentors and sponsors. Be open to new opportunities out there. Actively develop your own professional skill set. I’m a big believer in career development, courses, for example. I’ve always taken courses at every stage, such as a negotiation course at HBS; There are career development courses for women in academic medicine.

Recognizing there are many who read this article are considering medical school, the AAMC helps students as they apply to medical school and at all stages in terms of courses and networking. The opportunities to enrich one’s understanding about the abundance of career opportunities that exist are significant. Continue to remain focused on the issues affecting healthcare today and remain prepared to do your part of making a difference.

Eve Higginbotham SM, MD ‘79, ML

Vice Dean for Inclusion and Diversity at University of Pennsylvania, Perelman School of Medicine

Interviewed and Compiled by Felicia Ho

Eve Higginbotham SM, MD ‘79, ML

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