Intersectionality, Leadership, and Empowerment Drive Jagsi as a Woman in Oncology

Reshma Jagsi, MD, DPhil

Raised in England after her parents emigrated from East Africa, Reshma Jagsi, MD, DPhil, was taught a fundamental value from her parents: always speak up when there’s injustice. From a young age, her mother explained that women could do anything, including learning math and science, which her mother was not allowed to learn after 6th grade as a Muslim woman, Jagsi noted. Her blend of passions led her to pursue both social policy and medicine.

Now, Jagsi is the chair of the Department of Radiation Oncology at Emory University School of Medicine and Winship Cancer Institute of Emory University in Atlanta, Georgia, carrying her unique journey to further uplift fellow experts in oncology, regardless of their background.

“When I decided that breast cancer was the disease I wanted to treat, I became so committed to making sure that the treatments we discovered were reaching all of our patients and that we were ensuring the prevention of this disease, collaborating across borders, and making sure that we were communicating with our patients to empower them to make the decisions that felt right,” Jagsi explained during an interview with OncLive® following her participation as a panelist in the Women In Oncology event at the 42nd Annual Miami Breast Cancer Conference, as she highlighted her journey. “That's really what brought me to this wonderful field.”

In the interview, Jagsi discussed how her background complements her identity as a woman in oncology, her experience with a leadership role, and how she works to empower herself and other women in the oncology field.

How do the intricacies of your background tie into your identity as a woman in oncology?

There is this important concept of intersectionality that was raised by Kimberlé Crenshaw in the legal literature. It explains that you can't just add up the experience of being part of one group to the experience of being part of another group and understanding the experiences of someone who lives at the intersection of those identities. There's been a lot more work in recent years to identify the unique lived experiences of people with more than 1 identity that has been marginalized or minoritized in our society.

It has actually been a great joy of mine to spend some time focusing on the development of the workforce and ways to make sure that everybody—regardless of their background—has an equal opportunity to contribute because we know that talent is out there everywhere. We don't want to put up barriers with systemic and structural obstacles that make it more difficult for some people to bring their best to the field.

As a woman of color, I have seen how this can play out, and I have fortunately been able to be there as someone who people could trust their personal stories with. Because I'm a social scientist, when I hear a story, I naturally want to know, “How often does that story actually play out?” and “How can we make sure other people hear, understand, and act on that story so that we can all get to our shared goals of making the health of society better?”

As a chair of the radiation department at Emory Winship Cancer Institute, what does it mean to have a leadership role as a woman in your field, and are there any particular challenges?

For a period of time, I was the only permanent clinical department chair who was a woman at my institution. That has changed, and it's wonderful. It's hard to be the only in any room, so it is also a wonderful privilege because it allows the chance to transform expectations. Having leadership is wonderful because leadership is about helping groups of people to identify their whys and pursue that together.

I arrived at Emory at an ideal time. It was just as the limitations and restrictions of the COVID-19 pandemic were starting to lift, and there was a tremendous sense of urgency to come together again; to reconnect and define our collective why. There are so many values we all share. When we're in academic medicine or medicine more generally, we're committed to the health of society as a whole. [Not] only [are we] committed to making sure that every patient who walks in our doors receives the highest quality of care, but also that we learn from that experience, and use it to teach future generations who are going to provide that care. We are also committed to [finding those] discoveries that are going to make care in the future even better. To be a department chair is about all of that. It's about service to the tripartite mission and empowering the incredibly talented people in our field to contribute to their highest and best abilities.

How do you work to empower yourself and women early in their careers in oncology?

I will say that women early in their careers have contributed far more to me than I have to my mentees. We talk about mentorship as though it's a unidirectional thing, but we all have something to learn from someone else. I have been so fortunate to meet amazing mentees and amazing mentors across the course of my journey.

During the Women in Oncology event, I talked about my very first mentor in radiation oncology, Nancy J. Tarbell, MD, [at Harvard Medical School] who is the epitome of mentorship. She really taught me what it is to be available and truly invested in helping someone else achieve their definition of success, not imposing that upon them, but making them aware of all [their potential.] It's about listening to the person you're working with [as they share] their values and preferences and giving them all the information you can provide from your experience and knowledge, and then empowering them to be successful.

When I've done that, I have seen so many extraordinary people make tremendous advances. One of my mentees who was a resident when I was an attending physician—who I’ve learned more from—once came to me and said, “I'm part of a Facebook group that talks a lot about the diagnosis of breast cancer in African American patients. Why is it that we apply screening guidelines from studies largely conducted in Scandinavia and Canada, where there were very few Black women? Why do we apply those, uniformly, to the screening of Black women who are more likely to have triple-negative breast cancer, [a disease that] divides more rapidly and is more aggressive? Also, is it really okay to wait 2 years in between screening exams, or should we be doing things differently?”

As we talked this through, we thought about whether there was a way to do some kind of subgroup analysis, and there wasn't. There weren't enough Black women to do a subset analysis of the trials. But then, I had the good luck of having worked with Jeanne Mandelblatt, MD, MPH, at Georgetown [Lombardi Comprehensive Cancer Center], who actually does the CISNET modeling that informs those guidelines. [At the time,] I said, “I wonder if there's a modeling way to get at this.” It turned out that Jeanne took Christina Chapman, MD, from Baylor [College of Medicine], under her wing, and said, “Hey, let's look at this using the CISNET data.”

Ultimately, what came out of that were changes to the national screening guidelines for breast cancer. In the end, it wasn’t only for Black women but for all women. However, the science was driven forward by this bright, innovative young woman who thought differently from anyone else who had been in that space before, and that's why we need to bring people from different backgrounds together. We need to empower them. We need to connect them. We need to sponsor them. Sponsorship is this idea of someone who is a little bit more senior and has a little bit of influence being able to say, “Hey, you should invite so and so because they're going to do an even better job than I would for the thing you invited me to do.” Every time I've done that, I've seen science get better. I've seen service get better. I've seen our field get better.