By Ellen Basile, DO; Adrianna Gatt, MD; Laura Merlano, MS-III
Leadership and pay gender gaps are current and necessary topics for women in medicine. Recent studies have shown a pay difference of up to $2.5 million between male and female physicians over a career amongst surgical specialists, and only 7% of U.S. surgical department chairs are occupied by women based on a 2020 study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461563/
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2021.00461 Why women may lag professionally is the focus of many studies; reasons cited include gender bias, family obligations, and lack of support. In January 2023, we interviewed Dr. Adela Casas, Chair of the Surgery Department and Surgeon-in-Chief at Nemours Children’s Hospital in Orlando, to discuss her journey in medicine, her rise in pediatric surgery, and academic leadership. https://jamanetwork.com/journals/jamasurgery/fullarticle/2769902 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461563/
Dr. Casas immigrated to the United States with her parents from Cuba at four years of age. By the time she was eight years old, she knew she wanted to be a physician. She became the first in her family to graduate college and credits her parents with the ambition. Her father told her, “the only thing people cannot take from you, is your education.” She told us getting accepted to medical school was a challenge. Though “everything seemed to fall into place,” she expressed thoughts of unworthiness and being “out of place”. She felt she had to work harder to ensure her grades matched or exceeded her peers. The literature suggests that women struggle with imposter syndrome and self-doubt throughout their careers. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2749264 Many successful leaders, however, can persevere through adversity, as Dr. Casas so clearly did. She told us, “I don’t think I would change anything. The things that have been bumps along the road have gotten me to where I am right now.”
After graduating from The Medical College of Georgia medical with distinction, she completed her general surgery residency at The Medical College of Georgia, and a pediatric surgery fellowship at St. Christopher’s Hospital for Children. She highlights the importance of her mentors and sponsors during her journey. The literature suggests that mentor and sponsorship may be critical to career advancement, particularly for female physicians. Gender Gap: A Qualitative Study of Women and Leadership Acqu… : Anesthesia & Analgesia (lww.com) https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789909
One of her early mentors, Dr Robyn Hatley, told us “as a fourth-year medical student, she was better than my residents,” and she had a “heck of a good work ethic.” A notable aspect of her story includes being gainfully employed during medical school and moonlighting as a resident. One attending during residency took notice of her extra hard work, and provided support by loaning her a large sum of money. This sponsorship provided her the opportunity to focus solely on her fellowship, without additional duties. Sponsors do not typically put their own money on the line, but they do actively support recipients in moving them forward in their careers and making opportunities happen. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541787/
Dr. Casas began her career as a pediatric surgeon at St. Christopher’s Hospital for Children and joined the transplant team. When the transplant program went to Nemours Children’s Health in Delaware, she went with it. After six years at Nemours , she “wanted to progress” towards leadership. She was recruited for the Chief of Pediatric Surgery position at Sanford Children’s Hospital in South Dakota. While there, she was selected to attend the Executive Leadership in Academic Medicine (ELAM) fellowship program at Drexel University. ELAM is dedicated to women in medicine with leadership aspirations. Executive Leadership in Academic Medicine – Drexel University College of Medicine When the Department of Surgery chair position opened at Sanford’s, Dr. Casas applied. Although the position was given to another candidate within her department, he promoted her to the Vice Chair.
Ten years into her career, her former boss and mentor, Dr. Stephen Dunn, from Nemours reached out. They were recruiting a Chair of Surgery for the Nemours Children’s Hospital in Orlando. Dr. Dunn said, “I knew Adela was the real deal,” and “she could do anything.” Dr. Casas acknowledged that Dr. Dunn had opened the door with hospital leadership and advocated for her to obtain the position. Today, she runs a surgical department that has six division lines, 19 surgeons, and 17 advanced practitioners.
Dr. Casas is more than a surgeon and a leader, she is also a wife and the mother of four sons. This story would only be complete if we mention her family. When it came to childcare responsibilities throughout her career, she notes, “my husband really took the brunt of it.” At one point, her husband took an eight-year leave of absence to care for their children. She emphasized that without his support, it would have been challenging to practice surgery and achieve her career advancements and accomplishments.
When asked what her proudest legacy will be, Dr. Casas, without hesitation, said “the high points of my career are the kids I have taken care of for the last 24 years.”
The authors thank Dr. Casas for her time and the example she sets for us all.
Ellen Basile, DO
University of Central Florida
Department of Pediatric Anesthesiology
Nemours Hospital for Children
Ellen Basile is a pediatric anesthesiologist. She graduated from the Philadelphia College of Osteopathic Medicine, completed her anesthesiology residency at Drexel University, Hahnemann Hospital in Philadelphia and her pediatric anesthesiology fellowship at St. Christopher’s Hospital for children. During her career she devoted her time to clinical patient care and service. She has served in many leadership roles including OR director, Associate Chief, Program Director for two university fellowship programs, and most recently was the Chief of pediatric anesthesia division at Augusta University. She currently works at Nemours Hospital for Children in Orlando, and plans to spend the remainder of her career pursuing research, and moving the effort to close the gender gaps for women in medicine.