Essential Wisdom: Inspiring Future Female Physicians

Rashma Jhunja, MD - Internal Medicine

June 13, 2019 Carrie Dubeau Season 1 Episode 2
Essential Wisdom: Inspiring Future Female Physicians
Rashma Jhunja, MD - Internal Medicine
Chapters
Essential Wisdom: Inspiring Future Female Physicians
Rashma Jhunja, MD - Internal Medicine
Jun 13, 2019 Season 1 Episode 2
Carrie Dubeau

Dr. Jhunja practices as an outpatient Internal Medicine physician in Bloomfield and Wethersfield, CT. She earned her medical degree at the University of West Indies - St. Augustine Campus, Trinidad, West Indies and completed her residency in Internal Medicine at St. Vincent's Medical Center, Bridgeport, CT. Dr. Jhunja and I came to know one another through the Quinnipiac University Medical Student Home Program which provides a primary care experience during the first and second medical school years. She’s interested in Integrated and Holistic Medicine and plays piano in her free time. 

Show Notes Transcript

Dr. Jhunja practices as an outpatient Internal Medicine physician in Bloomfield and Wethersfield, CT. She earned her medical degree at the University of West Indies - St. Augustine Campus, Trinidad, West Indies and completed her residency in Internal Medicine at St. Vincent's Medical Center, Bridgeport, CT. Dr. Jhunja and I came to know one another through the Quinnipiac University Medical Student Home Program which provides a primary care experience during the first and second medical school years. She’s interested in Integrated and Holistic Medicine and plays piano in her free time. 

spk_0:   0:00
welcome to essential wisdom. Inspiring future female physicians. Ah, podcast for engaging and informing the next generation of women in medicine. My name is carried a bow. I'm 1/4 year medical student at the Frank H. Netter, MD. School of Medicine at Quinnipiac University. Essential Wisdom is a podcast for discussing the joys and the challenges off being a woman in medicine through the sharing of stories and advice by women who mentor us. Take a seat with me at the desk of the mentors, come along tow, walk the holes of the hospitals to experience residency and life as a physician personally, as we get to know these phenomenal physicians and scientists. Help me welcome Dr Rashmi Ginger. Dr Ginger practices as an outpatient internal medicine physician in Bloomfield and Wethersfield, Connecticut. She earned her medical degree at the University of West Indies ST Augustine campus, Trinidad, and completed her residency in internal medicine at ST Vincent's Medical Center, Bridgeport, Connecticut. Dr. Genya and I came to know one another through the Quinnipiac University Medical Student Home Program, which provides a primary care experience during the first and second years of medical school. She's interested in integrated and holistic medicine and plays piano and her free time. Welcome, Dr Ginger. Thank you. So as we normally get started, we'll just kind of begin from the top. The one thing that we always ask all of our guests on the show is to tell us about your path to becoming a female physician.

spk_1:   1:42
So my path was sort of interesting. Lead me all around the world and back home to the States. So I went to, um, high school in Connecticut. And then after that, I did my premed at Boss University. During that time, I had plans to pursue the masters of medical sciences immediately after my premed days. Um, my folks are from India. Um, and my mom had found out about a program there for non resident Indians called in our eyes. So she had come back sometime in beginning my senior year and told me about this program. I was a bit reluctant, of course, to go just even though, you know, culture. They grew up here in the States since I was about three. So had a little hesitation, and I had had already planned out my path. However, both my parents, when we talked. They in their minds. They were looking at it like I was quote wasting sometime during a master's program because they knew that I had wanted to be a physician from a very young age. So they thought that why not get this done as soon as possible? So it sort of took the chance and wound me up in India and then the West Indies. And then I came back to, um, local to a local hospital near where my folks lived. So it was sort of securitised. But I'm looking back and really privileged to have witnessed medicine in many different countries, many styles. And I'm really grateful for that experience.

spk_0:   3:07
So you mentioned that you had always wanted to be a doctor from when you were very young? Yes. Was that continued through every stage of your education as well?

spk_1:   3:15
Absolutely. And the thing that kind of it's scary when I look back as an adult is that I never had a Plan B, so I never actually had that choice. What if I didn't get into med school? Or what if I didn't, uh, you know where there wasn't able to pursue my dreams? I just never had another option in my mind. So I just new for me. I think it was really a calling like he knew from a very young age. You know what you want to be when you grow up and my answer is always Doctor,

spk_0:   3:40
Um, did you have doctors in your family? My mom's

spk_1:   3:43
a nurse. Um, other than that, no, no other physicians in our family. Yeah,

spk_0:   3:47
in terms of your path to choosing, then internal medicine, integrated

spk_1:   3:51
whole integrative medicine. Holistic healing, I think can be very intuitive. To me, it just made sense. Is the only way really to practice medicine, even though, you know, I do that my primary work is as an internist, I do sort of look at the preventative aspect well being and things like supplements and natural remedies as well. So, to those of my patients were open to these type of things. I do discuss that with them because I think that's a that's a real integral part of health and well being and also gives the patient sense of power that they know that there are things they can do to help their health. This well, that doesn't always necessarily come from a prescription or surgical treatment or something. So, um, I kind of always leaned toward that. And then when one of my colleagues started introducing that concept to our group, she set up in integrating Wellness Center and I was very happy to be part of that after getting certified. And did you consider other specialties so honestly had no clue coming out of my residency? I didn't know that I greatly enjoyed the clinic time that we had. And I also love the hospital. So my first job was a hospitalist before I went into outpatient internal medicine. It was very exciting and very fast paced, which I enjoyed the challenge of enjoyed interacting with all different specialists and patients and acute care setting. But we were also like a very new group of hospitalised, so we were the primary ones to establish this hospital's program at a very large center. So early on it was it was very hard work, like anything building up anything from scratch. And, uh, there's a lot of hard work, great experiences, but I think my transition into outpatient setting came because I realized that was really missing that work life balance that even though I was working one week on one week off weeks off, I was just catching up on sleep and basic things that I absolutely couldn't get done the weeks on. And I realized I was missing a lot of things in my personal life. Yeah. Can

spk_0:   5:54
you talk a little bit about work, life

spk_1:   5:55
balance for you and what that looks like? Absolutely. So that was part of my motivation to switch into outpatient medicine where I had a little bit more control of my schedule and I had weekends and nights and and here you can kind of tailor. You know how hard you want to work at what pace you want to work, etcetera do

spk_0:   6:13
have a large practice that the U. S. O.

spk_1:   6:15
That sort of just, uh, happened. But I enjoy it, but it's I think it's really important to to recognize the boundaries between work and personal life. So that was one of my lessons. I think going from hospitalised medicine into outpatient is that if we don't create that and we don't have that self care piece, it's very difficult to care for everyone

spk_0:   6:38
that kind of takes me to something that I usually ask at the end of the interview, but I think it seems like a good time. So then, in doing work, life balance, part of that is setting priorities for how you make the work life balance. So one of the things I'd like to ask is, how do you set your priorities and how

spk_1:   6:52
do you think that fall? He has absolutely so in the office, for example, the priorities are patient care. So we're inundated with lots of things like, uh, you know, lab test, that common reviews reading, consul notes, etcetera, staff interactions, all the other support part of taking care of patients first and foremost, I think what happens in that room for me is the most important thing after that. You know, I tried to obviously address delegated tests, etcetera. I think the other piece of from Where I come from an outpatient setting is also the interactions with staff and just utilizing the roles of the people that work with you. I think that's very important to make your life easier to, because that's part of that is part of the work life balance that the balance and work, so to know everyone, strengths and weaknesses when you work with and utilize them appropriately, I think that that has a big it's a big factor. How does being a female play that? That's a very interesting question. So as far as we've come in this day and age, you know, unfortunately, there are still it is still, I think, a male dominated profession. It's changing. So currently, you know, there are almost as many of not women men in medical schools and in this field. But joining the group that I meant also, um, you know, there's obviously a whole variety of generations of physicians, and it's interesting. I took over my outpatient practice from a male physician who had been in practice for several years and probably seeing patients in their team since they were in their teens. So some of those patients, when I first took over his particular male patients, would ask me, they say so I've never had a female doctor before, so my answer to them would be while we do exactly what male doctors do but better take that left. It was interesting because it made them think about it in a different way. Yeah, so Yeah, but I think that's it. I'm there Still things like, uh, there's disparity in payrolls and et cetera. I mean, these air, you know, facts. Unfortunately, that's still occur this day and age. I think it's we're getting to the point where we're gonna be true equals two men in the workplace in medicine. But And I think, you know, with my generation and younger, I think we're starting to kind of see more of, ah, level playing field. But it's been, you know, at least the time when I was a resident in training, too. It depends people. It's interesting to see the perceptions of how people view a male physician versus female physician. Specifically, patients are also colleagues and staff. Yeah, I think, um, I think both I think both actually. So

spk_0:   9:35
then, in terms of your path to becoming the doctor you are today, one of the things that I think is important is mentorship. And as also

spk_1:   9:42
why we're doing this podcast. So I would be curious if you had anything l mentors in your process. I absolutely did. Actually, one of my most memorable ones was a senior resident when I was an intern in internal medicine in my residency program, and one of the things she taught me, which is still so crucial for today, is delivering bad news and having the code talks with family. So I did my I Su internship with her, and she wasjust amazing the way she confidently handled like very high emotion situations in such when, you know, we had to talk about palliative care and comfort care, and it used to amaze me at the time. Because I was just a little intern was like a fly on the wall, listening to her speak with patients and families about really crucial decisions. And I I was wondering, How can she do that so confidently? And we're talking about somebody's life here, but I think it really the more you do it, the more it becomes sort of you find the wording, you know, and like anything, it takes practice. But she really made a big impact on me the way, and she was very logical. I just loved her approach to things, and, um, she was a great teacher. They had some really great mentor. She was one that stood out in my mind.

spk_0:   10:56
Yeah, she served to somebody that you wanted to emulate. Absolutely. Yeah. I think one of the things that I was reading in preparing for these conversations was that there may not be a lack of mentors out there for us necessarily, but that there is a lack of people Women existed in the field. Now that we have to look up to, um, just by sheer numbers of you know how doctors have changed over time. So, yeah, certainly having somebody to emulate is very important. I know I've been very fortunate with that. And, um, yeah, I think that's a very important point. You were talking about the process of delivering bad news and going through that kind of leads me into this idea of the challenges of being a female. But then also maybe the joys of being a female. And I wonder what your thoughts are on if being a woman makes doing that kind of an activity any more natural or not, or anything

spk_1:   11:51
like that. It was really interesting. And I do. One thing comes to mind when you asked me that about the fact that I think women in general, we can multi task. In some ways he be better than men, not everybody, but just that's my personal opinion. And I think when you're in a room with a patient or in a clinical setting with a patient, you're not just taking care of their physical Selves. You're taking care of emotional well being, their psychological well being. So I think that's something that is very important and sort of treating people as a whole being. So people come in, they want to talk. I mean, they're certainly lots of things that play into somebody's physical well being, and the other aspects are as important as the physical piece of it. So sometimes we're listener. Sometimes we're, you know, acute diagnostician. Sometimes we're counselors. So I think this is I think this is something we're women can sort of utilize that ability to look a TTE many aspects of health care

spk_0:   12:52
like that. That's something I hadn't heard before. Um, what is probably like the greatest away that you have and

spk_1:   13:00
the doctor? The greatest joy is being told that you made a difference, and I always say that if I could make a difference even in one patient in my day or in my week. That would make it all worth it, because it's very easy to get caught up in the humdrum and you go in and your schedules like X, you know, am to PM and you're seeing patients and you're making call back getting task. I had a patient. Interestingly, vory Anno older woman, probably in a hurry eighties. And she hadn't seen a physician, maybe 20 years. And she came into me and I met her for the first time, and it was very interesting physical in your patient exam. She really wasn't interested in any of her screenings, she said. Why? You'll find I'm doing well. I got this far. It's a

spk_0:   13:46
sure you did. I said You might

spk_1:   13:47
want to consider some of these things, so she sort of went home. I don't want to overwhelm her with too many things. And I saw her again, like about two weeks later in the office, and she came in for shortness of breath. So I listened to her and her heart beats on a little irregular. So we did an E k G. And she was in rapid a fib and her blood pressure was a little bit lower. Then she was running on Dhe. She she was dis Nick on exam. So I I explained to her that I really found she should go into the hospital, that she probably needs a mighty medications, et cetera. She was very, very reluctant. She said, Now be okay. Just give me a pill. Be fine. So anyhow, you know, a little bit of pushing. She loved me to call 911 and center into the hospital. So about a week later, I should aid stabilizer, of course. And she went home. And a week later, I come into the office and there's a little card on my desk, and it was just a very simple sentence in the card. It's a dear Dr Jorja. Thanks for saving my life. And she signed her name and that was it. So it was in that moment I realized that, you know, with all my leg breaking my head against

spk_0:   14:48
the wall, trying to convince her about

spk_1:   14:49
everything that just this, that I think something finally dawned on her that you know what? Maybe medical care is a little important. Yes. Yeah, That was a great moment So it's things like that. Yeah, it's things like that that that really make it worth it.

spk_0:   15:04
So straightforward. Yeah, thanks for E. That's awesome. So on the flip side of that, one of the biggest challenges that you say you face, So one of the

spk_1:   15:13
biggest challenges, I think, um, it is sort of I think the work life balance is a big thing to focus on because even as med students are premed, you know, med school and prevent everything it could be. So all consuming exam after exam, test after test. And you know your goal driven and you want to get into whatever your specialty is and et cetera. So I think the most important thing is to realize that not only in med school and college, and even afterward it's very important to try to maintain that personal piece of your life, too, because we need to recharge, We need to recharge. It can. Even as a practicing physician, it becomes overwhelming, sometimes under your control and sometimes not. So I think that's very important to keep the barrier between work and and your personal.

spk_0:   16:02
How would you say that you do that? So one of

spk_1:   16:05
the things. And maybe this comes down, you know, to the previous question with priorities to. I like to finish all of my tests for that given day that day because it's for me the time that I'm out of work. I don't want to be thinking about it. I don't want to feel like there's something pending or that I might miss something because I didn't review this lab that day. So it is difficult. I do have a large practice, so it's not, you know, I do have probably. At least now we're out on behalf of non patient like direct face to face contact type of ours per day. But once I leave, it's like I don't have the weight of that sitting on my shoulder. So then when I go home, I can truly do the things that I want to do and not worry, and I think part of it. Maybe just I have the, you know, the ability do that. Now I'm saying I don't have kids and et cetera, but you know, I try A I would think that in the future, I'd like to try to maintain that just so I have that sort of whether it be a time, you know, or just a stop point and then to proceed with the rest of your life Dust in there,

spk_0:   17:07
not taking work home. It's hard to dio it is difficult.

spk_1:   17:10
I'm not gonna say it does come with his challenges, but I think it's or at least drawing a barrier in your day. You know, may not be, I mean, the prioritizing pieces. Obviously you want to do with the emergencies first, and then if things can wait. But if you do, you have to let go. You have to let that go and not let it run through your head the rest of the time. Otherwise, there is no balance than then. You're not really to shutting off.

spk_0:   17:33
Yeah. Would you say that for you? Um, doing that progressed throughout medical school. Was that a skill you had to learn? I think that's part of my O C D. Nature s. So I think we all are mostly

spk_1:   17:45
due to some degree in this feels Yeah, but it's it's it's difficult, but that's where you have to also recognize your own strengths and weaknesses and no, you know, I know that if I left things pending, my brain would not let me rest. So this way I sort of get that. I am able to truly, like, turn off and have a little bit of protected time for myself.

spk_0:   18:08
If you have any resource available to you during the day to make the work life balance easier, what resource would you want? I think part

spk_1:   18:15
of it is, and again, I'm sorry if I'm repeating. But part of it is also recognizing your own strengths and weaknesses and recognizing that of those around you. So you know medicine and many. No matter where you practice, whether it's in a hospital or outpatient setting, it's teamwork. So if you know that certain people in your office or good at certain things and give that to them like delegations very important. Andi, this may be a little bit more on the business side of medicine, but I think even in your own life, like your medical assistant, you're if you have a nurse navigator. In my personal day, I mean, we've started using mid levels in our practice, and it's made a huge difference. But I think the one resource, like before asked me Today I think a nurse, navigator or social worker would be very helpful because there's a lot of non physician work. I believe that still a lot of physicians do S O You want to maximize your physician required hours with things that you should be doing, We should be doctoring, you know, And we should have, like, different staff to help with some of the maybe non physical things that we do because a lot of paperwork, a lot of sort of things that we have to do at the end of our day. The non face to face can maybe be don, I think, by other members of the health care team. So that's really important to sort of utilize, you know, staff and that team kind of approach, I think, to make life easier. Both that worked at home.

spk_0:   19:42
Do you think that's happening in outpatient settings? I thinkit's

spk_1:   19:45
coming around, definitely. You know, a couple generations ago, people didn't have a lot of faith in mid level practitioners and nurse, you know, furans, etcetera and P. A s. Andi, think specialty by specialty. I think a lot of surgical sub specialties have utilized them first and intermission was a little bit slow to catch on. But now I think a lot of offices air utilizing them and their part, they're valuable part of the health care team. So, you know, it really does sort of make things easier.

spk_0:   20:14
When you were faced with a pivotal challenger of point in time that you had to change your path Possibly, Um how did you deal with them? Yes,

spk_1:   20:23
I think going back to I think the decision actually to leave the hospital was a big thing for me, mainly because I was comfortable. I was very comfortable in where I wasa I knew the staff. I knew the routine despite the fact that it was really invading my personal life. That was a big, big challenge for me to leave a place of comfort and step into an area where had been away from for some time, like, you know, since actually resident seasons. We did clinic, so that was a big step. But I think the one thing that I just remind myself of it is, you know, we have to overcome our fears in order to progress. And, hey, if I didn't like it. Then there's always another route, right? So nothing's really permanent. Doesn't matter how young or old you are. You're you're in control. You can make those changes. Um, so, yeah, that was, You know, I spent almost a year, though from the time that initially was thinking about doing outpatient medicine, and I was kind of waiting to see how things evolve with our hospitalist program. And, you know, there were some other factors there, but I think in the end it was a good decision because the the longevity, the longitudes nature in which we care for patients outpatient setting the bonds, reform with people at the end of the day, it's about the human connection for me and I I enjoy that enjoy taking care of patients and their parents and their grand parents. I mean, I have, you know, a handful of patients who span like couple generations, and it's really, really a cool experience to be part of that.

spk_0:   21:50
No. Is that one of your favorite things about being you natural that it's

spk_1:   21:53
absolutely the connection, the human connection and over time you're seeing people when they're well in the hospital, you know, emotions are high. There's lots of acute settings, so people don't behave necessarily the way they would in a normal setting. And plus, you know the emphasis on preventative care I found. Even as a hospitalist, I was always questioning likewise this person back for the third time again, back with another COPD exasperation back with another. You know, men on Steph me e realized there was something that was missing on the outside of it. So I was my brain was always looking for Okay, how do we prevent this from happening again? So I think that kind of, you know, that's what led me into more of an outpatient arena. I feel like I could I could make more of a difference this way.

spk_0:   22:35
Yeah, it's beautiful. The process of overcoming the fear t do something new. This is like a theme, actually, that's coming for me personally. And other talks I had with mentors on dhe. They've said like every single day, you should be doing something that you're really uncomfortable with,

spk_1:   22:52
correct in order to grow. Yeah, I think that's absolutely valuable. So this also applies for personal life. You know, if there's something if you wanted to learn an instrument. If you wanted Thio, go hang gliding or it's

spk_0:   23:02
gonna bake or

spk_1:   23:03
something. I mean, it doesn't have to be all high risk behaviors, but I think it's a good idea mentally, because we're on our own worst enemies when it comes to progress when it comes to change, I think we slower own Selves down because of that fear. So once we're able to conquer that fear, you can literally you can do anything. You could do anything that you want to do.

spk_0:   23:23
Advice for pre Med students

spk_1:   23:26
Have fun. Have fun because it is a serious enough business. You know you're inundated your face every day with pressures from yourself, your family, your competition in school and all of that. I think the most important thing is have fun, find some fun in it and spend time doing those things, whether it's within class or work. But even in your personal life, enjoy. The ride

spk_0:   23:49
like that relates to the work life balance, too, because once you define that behavior of having fun, then you know how to carry that through the process. When it gets

spk_1:   23:57
hard. Yeah, it's important to enjoy yourself, whatever it is you do. I mean, there's there's not any And if something doesn't work out initially, then try something different.

spk_0:   24:06
And then what about four students, women who are medical school or trying to define their career choice That comes along

spk_1:   24:17
the same thing. So it's It's interesting, you know, like I like I said, I didn't even know what I want to do. When I first came out of residents, it just kind of did the hospital's thing because I knew I worked on Oz, but we did a residency in a hospital, so it just seemed the natural thing. Um, I think the most important thing is to find a couple of years that I liked infectious disease, for example, at one point considered doing I D. But then I said to myself, I can do this in internal medicine and just be good at it. So, to be honest, it's probably not. That's one of the consul's. I probably really call because I feel confident in doing that. Um, I think it's important to sort of identify what you like, and if it if it fits your idea of and we'll help you maintain that work life balance. I think that's important to go for it. I had wanted to do a B, g Y n at one point or even surgery. Think surgery was my first passion in medical school. But when I looked at it and being a woman and I knew that I'd want a family someday and just looking at sort of the the scheduling and such I said, you know, that's probably not gonna fit into what I want eventually. So I didn't really pursue that. Do I have regrets now? No, I don't because I think I've found what I wanted to do

spk_0:   25:24
for your process of reflecting and doing those things was there's, like, a habit that you had that helped you process all this lot. Sir, You know, I think a

spk_1:   25:33
lot of times I mean, I think again, as women, we always have things running on. I call it in the back screen of our behind stage. Eso we d'oh! You go through your day, you go through your schooling, you go through your your personal life, etcetera. But I think there's always stuff going on behind behind the screen. So I think you know it's important. Thio also have time for that. So reflective time. This is very important, as you're going through all these experiences and tryingto figure out what what direction You want to go in? Yeah, but again, it comes back to that figure thing. You know, don't be afraid to try something. And if if it's not working out for you, then there are other options.

spk_0:   26:16
I love that. Thank you, man. Thank you for that piece of wisdom. Thank you so much, Dr Ginger. For joining us on essential wisdom inspiring future female physicians for this second episode. It was an absolute delight to have this conversation with you. And I know that your wisdom, your advice, your mentorship will be well loved and appreciated by all the women out there who are planning their career. Thank you, listeners for tuning in for the second episode. I can't believe it. We made it to the end of our first week and we're almost ready for our next week. I'm just about there. We have our plans. We have two surgeons coming to talk. I loved recording these episodes, and I'm gonna love sharing them with you. So I hope you have a great time listening to them. We're gonna be joined by a breast surgeon and we're gonna be joined by a congenital cardiac surgeon next week. If you're interested in that, you want to tune in. You want to hear a little bit more? I have a couple things for you. You can check us out on apple podcasts. Go give us a rating. Five stars. That's what I'm talking about. Otherwise, you could just check us out on Spotify, podcasts or online at essential wisdom dot bus sprout dot com. If you wanna learn a little bit of more information about these lovely female physicians, please check out my website. Essential Wisdom inspiring physicians dot com. If you go to the website, you can navigate through information about the podcast, which will give you thes schedule for the rest of the season, as well as some background information about each of these lovely physicians with a little quote. And there's also a comments box, so please go to my contact page. Leave me a comment. Drop a question if you have feedback. If you have things that you want to hear, please leave them. This podcast is about you. This podcast is about building up our young women and informing one another so that we continue to rise and advance as women in science and medicine have a great week. Happy Thursday. Happy almost Friday, everybody.