Rakhee Bhayani, MD, is an associate program director of the Internal Medicine Residency Program at Washington University School of Medicine. She came here for medical school and stayed here for residency. She is also the co-founder and director of the Forum for Women in Medicine, a society that brings together women physicians across campus in all walks of life. She can be found attending in the busy Primary Care Clinic at the Center for Outpatient Health and is a familiar face to countless residents.
Shaikh: Let’s start with how you got into medicine.
Bhayani: I was a biomedical engineering major at Duke. I always loved science and wanted to go into medicine. So I thought that was a great way to meld both of those areas of interest into one. During residency, I liked a lot of different fields. I liked cardiology; I liked GI (gastroenterology); I liked pulmonary (medicine). So, when it was time to decide about fellowship, there wasn’t one that stood out. I eventually found love for primary care medicine and the patient interactions that came with it.
What are some of your favorite things about primary care?
When I was at Johns Hopkins seeing my own patients, I really loved the continuity of patient care, being able to work on the issues they had and getting to know them. Then, when we moved back to St. Louis and I started working in the resident Primary Care Clinic, I wasn’t sure if this was something I would want to do long-term. I thought I’d miss the patient interaction and developing relationships with my own patients. Soon after starting, I found a love of teaching and working with the residents and medical students. It’s actually great because you really get to know residents and watch them grow over the course of their three-year residency, and still have a significant amount of patient interaction.
Do you remember what your first day as an intern was like?
I went to medical school here at WashU, and my first day was in the ICU. I was kind of terrified because writing an order for the first time is a little intimidating especially when the patient is so sick. I had a fantastic resident who was really supportive and patient and some terrific nurses who really helped me get through those call nights. It really brought to light how important having that support team around you is because that’s what really helps get you through some of those difficult moments.
What does your support system look like?
I think (a support system) is important, no matter what stage you are in your career. We don’t have family in the area. So, when we had young kids, the fact that I essentially worked clinic shifts, made it easier for me to move things around when needed. I could switch a clinic shift with another faculty member to be at home when my kids were sick or if there was a field trip or some other school event. And that was a really important aspect to me in my job. I also got to know many of the parents at school to help with early dismissals or other things that came up at school.
What does work-life balance mean to you?
I like to think there’s no such thing as work-life balance. Some days, you may be focusing more on family and some days you may be focusing more on your career. I think that changes, ebbs and flows based on where you are in your career, if you have kids, how old your kids are and whatever other responsibilities you have in your personal life. For our family, I made the decision early on that I wanted to work part-time. I was fortunate enough to find a job that I loved and leaders that supported that choice.
What were some of the times in your career where you felt like, because you’re a woman and a mom, you have to make some choices?
I think the biggest thing for me was when I had to make a decision about whether I want to pursue a fellowship. When I started residency, I was convinced I was going to do a fellowship in cardiology. As time went on, I found that I liked a lot of different fields and couldn’t decide. At the time that I was in residency here, not very many people chose primary care. While working at Johns Hopkins I realized that a career in primary care was fulfilling and pursuing a fellowship wasn’t as important to me anymore. Then, after having my daughter, I decided I wanted to find a job that was part-time.That has been a good decision for our family. I think I went on every single field trip with both of our children, did all of the class parties, and participated in various school committees. All of those things really brought a lot of joy and fulfillment to my life. But at the same time, I was able to come to work and have a career where I was fulfilled with what I was doing.
How did the idea of FWIM come up?
That was another decision point that came along in my career. Dr. Fraser asked me if I would want to create a professional development program for women trainees in the department of medicine. I thought to myself I don’t know if I’m the right person for this or if I have the qualifications to lead these efforts. I’m so glad I took a chance because I actually really love that aspect of my job. I love bringing people together, scheduling programming for the trainees and faculty. It’s filled a need for skill-building and community building for the women physicians in the department.
You talked about fulfillment and joy. What brings you joy?
At work, I love interacting with house staff and the lifelong learning (that comes with working with them). I really value the bidirectional learning that happens at work. On a personal level, I value my part-time work schedule. When my girls were younger, we would really make the most of those days by going to the zoo, Magic House, or Botanical Gardens. Now it’s different because they are older and in school. However, even now those days off give me more freedom in my schedule for scholarly pursuits that don’t overflow into the weekend and more often, for all of those things that bring me joy and allow me to start the work week energized and ready.
Are there moments where you have felt burned out?
You know, I really haven’t. I’ve never felt burnt out. I feel fortunate. I really love my job. More importantly, since I’m part-time, I can create some space for self-care. It was a conscious decision that we made because my husband worked so many hours that I really wanted to be able to have some presence with the kids as they were growing up. That’s given my fulfillment both at work and in my personal life.
What are some times where you felt guilt for putting work first?
The first time I had to drop my daughter off at daycare, that was really guilt-inducing. You’re dropping your child off with strangers basically. It’s their first time, so they’re crying and then you’re going to work and you think, “Oh, my goodness, I’m a terrible person, I’m a terrible mom, I should quit my job.” These irrational sort of thoughts came to mind. However, within 5 minutes I got a call from the daycare, that she’s smiling and fine. That was reassuring, but it was a tough moment as a working mom.
What are some ways we can empower women to be leaders in medicine?
I think just having role models is very important. If you can’t really see that out in the workforce, it’s hard to imagine how you can get there. Being able to see women in leadership positions is important. As women residents decide their area of specialty it’s also important for them to see women in the various fields. For example, there may be women cardiologists but in the subspecialty of electrophysiology, there is a very small percentage of women in that field. So having those role models across various specialties is really important if we ever want to reach gender equity. Providing women opportunities to come together to network, share wisdom, discuss challenges and strategies can be really powerful. For example, trainees may think, “there is no way I could do this field and have a family.” And then you meet women in those fields, you hear about how they manage it, their family or household with their thriving careers… having that opportunity to share stories is really important.
How can we pick our role models and try to get the most out of these relationships?
That’s a great question. I think the best thing that you can do is be open to any opportunity that comes to you. If you happen to be at a conference, ask women not just about their challenges, ask them about what they love about their job. Most people enjoy sharing their story with you. Most importantly, really make a concerted effort to reach out to them afterwards. There are many ways of doing that, like social media or email. Developing those relationships can be rewarding.
What is some advice you would have given yourself when you were younger?
Don’t compare yourself to others. In medicine, we go from high school to college to medical school to residency and fellowship. You’re on this path that you’re following, just one thing to the next without really taking time to stop and think about what you really want to do, but what you think other people think you should say, or what everyone else wants to hear. That is why not really worrying about the comparison part is so important. When I started working in the medicine clinic, when I was asked “What do you do?” I would be like, “Oh, I’m just, I’m just, I just supervise residents in the clinic.” And my husband heard that and said “Why do you always say, you’re just this? You love your job. You’re contributing in a significant way. Why do you qualify it like that?” And I said, “I didn’t specialize or anything.” And as time has gone on, I’ve realized I’m not just this, I am this. It’s important to find your voice and value. It’s also important to be able to pivot and be open to opportunities that come your way. Most of the time careers don’t flow as an upward ladder, they often have little side journeys and adventures along the way, like I’ve had with my leadership role with FWIM.
What makes you most proud of yourself?
I’m proud of the fact that I was able to cultivate a career that I really loved by fulfilling my passion of working with residents but also having that time to focus on family.
Preet Shaikh is a third-year medicine resident with an interest in cardiology and women’s heart disease.