What got you interested in EDI and pairing it with ophthalmology?
One of the principles that I've always lived by is respecting people and making sure that everyone feels seen and heard. And unfortunately, for minoritized groups, that often is not the case. I’ve always had a lot of empathy for that. I grew up in South Porcupine, a part of the City of Timmins which is a small community in Northern Ontario. The city itself was diverse and they celebrated multiculturalism, but as a woman of color, there were microaggressions that I did experience sometimes in my day-to-day.  What really got me into the EDI space as an ophthalmologist, is my involvement with academia and the various leadership roles I've held over the years, some of which included being involved in the residency selection process (CaRMS). In academic ophthalmology, we’ve come to recognize that there are different areas where we can do better in providing more opportunities for exposure and access to ophthalmology as a specialty. (…) In my national leadership role as president of the Association of Canadian University Professors of Ophthalmology (ACUPO), we had an initiative involving all ophthalmology academic centers in Canada to look at different elements and phases of the CaRMS process. All department chairs and program directors worked together to come up with various strategies that we can implement at our different centers to make the application process more fair, equitable, and accessible to all applicants.
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‍What barriers or biases have you observed specifically within the field of ophthalmology for individuals from equity-deserving groups?
There are a number of barriers that we need to keep in mind. The first being access to electives. Since COVID the opportunities for electives have really diminished. We’re trying to get back on track by opening streams to allow people in, but there are still challenges associated with that. An example is resources available at universities where capacity may not allow for a number of students to come through. In addition to that, not all students have the finances to travel to various centers for in-person electives. Some students don’t know enough about ophthalmology to be interested due to limited exposure in undergraduate medical education. For medical students who don’t have relatives or close friends who are faculty members in academic centers, there can be a perceived bias and assumption that applicants who have these connections have advantages or perceived advantages of knowing how to navigate the system better. This may discourage students from applying to or even exploring the specialty since it’s such a competitive field. This is an important concern to address, so that regardless of your connections, economic situation, or personal background, the opportunity to pursue ophthalmology as a specialty should be fair and equitable. We are working on this at ACUPO with recommendations for EDI training for selection committees and by preparing conflict of interest guidelines. Also, some students come in with a lot of research and other students have not done as much, if any at all.  It’s important to really look at what is deemed a “good candidate”, so that it's not necessarily that you've published 30 papers; have you worked with the homeless or had other experiences that have developed a totally different skill set that’s also valuable, as an example.. (…)The idea [in medical school and with extracurricular activities] is to  develop your understanding of what an area of specialty is, what your compatibility with that specialty is, and then to process what you’ve learned through your participation in various activities. (…) The output matters, but it's the lessons you learn in your journey and then share that really demonstrates your understanding, character, and commitment to whatever you chose to do.
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‍How do you conceptualize supporting individuals from equity-deserving groups? How are you contributing?
In academic ophthalmology, we're encouraging our departments and residency programs to establish formalized mentorship programs for learners at their centers. Also as you know, the Canadian Ophthalmology Student Interest Group (COSIG) is starting a mentorship program for medical students. At ACUPO we’ve offered support for this initiative by having faculty available to mentor. In residency, many of our programs have formal mentorship programs where a resident starts residency, and while they’re completing their first year or two, they see who they feel most comfortable with, and continue their relationship from there with a faculty member as formal “mentor-mentee”. Where there is not a formalized program, most have informal mentorships where you can still learn from faculty members’ experiences.  This leads to another important aspect of mentorship, which is sponsorship. So when you work with mentor who gets to know you and your goals, they can offer further support by introducing you to people and opportunities who can help you achieve your goals as well. While contributing in these ways in more traditional leadership roles, my passion project, Docs in Leadership, is all about supporting and educating medical trainees, physicians and fellow healthcare professionals through webinars in various areas of leadership, well-being and EDI. I’m launching a free online community in January to make these resources accessible and available to all like-minded people in our field.
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‍How do we encourage individuals from equity deserving groups to apply for medical school, or leadership positions, without making them feel tokenized or singled out?
From my perspective the key is to increase awareness and exposure to leadership development from early on in education. What I mean is to incorporate structured leadership development programs in a graduated way right from undergrad, whether through university programs, healthcare organizations, or evidenced-based initiatives like my online community I mentioned, as examples. By incorporating leadership curriculum into education early on, everyone is gaining skills and competencies that can help them achieve leadership goals if this is something they are interested in. This approach levels the playing field without having to tokenize or single people out, and also gives an opportunity for those who have a knack for leadership to be identified and developed further earlier on.  

‍What do you think it means to people in the communities you are part of/represent for you to be in these leadership positions?
My motivation to be involved in leadership has always been driven by my own interest and desire to give back and contribute, and to experience and learn more and more. Even though I faced challenges and barriers at times, I never really thought about how my involvement impacted the communities I represent. Thinking about it now as a visible minority woman, it’s very meaningful to reflect on feedback from students and colleagues I’ve worked with over the years.  The overall theme from students and colleagues I’ve mentored or coached is that all things suddenly seem possible, and that the feelings of resistance they may be experiencing become something that diminishes.It seems to give them permission to try, and also, it makes them feel as though things are achievable. Those two levels of impact to me are very powerful in the sense that I've always believed in working in alignment with my values and principles and of aligning my goals with those. It makes it a lot easier to break through barriers and just to move forward, regardless of whatever obstacles you face.”  
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‍Would you like to share any experiences where your identity or your background positively influenced your interactions with, with patients or colleagues?
Absolutely. My parents immigrated from India in 1971and I was born a couple of years later in Timmins, like I mentioned earlier. While both of my parents are fluent in English, [at home] there were times when we were growing up that they would not answer a question if we didn't ask in Hindi to help us learn the language and maintain a cultural connection to our background. What’s been impactful about that is my patient interactions with those from India – elderly patients who don’t speak English as an example. I’m able to speak with them in Hindi and there have been many instances where they’ve said (in Hindi), “It's so nice to be able to speak in our native tongue,” and that it’s brought them such relief and comfort. There is a satisfaction that comes with that – being able to connect and communicate through language and an understanding of cultural sensitivities.  When patients come to see us, they're often worried - they don't know what's going to happen, particularly if they're about to have surgery. If you're able to connect with patients at a personal level, it becomes really helpful and comforting for them.
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‍What are some barriers to developing emotional intelligence and why is it important?
In my view, emotionally intelligence is at the heart of what brings people together in meaningful ways. It can help us manage our stresses and deal with important issues like our own internal struggles, interpersonal relationships, and more practically, conflicts at work and issues relating to EDI as examples.  If we are self-aware and understand how we view the world, we interact in the world differently. As an example, when I was in elementary school, I remember a classmate of mine who often used to call me discriminatory names like “Paki” as an example.  That used to really bother me. (…) Thinking about it from an emotional intelligence standpoint, how did this experience impact me? What am I still carrying around in myself about that, if anything, and how does what I’m carrying impact how I interact with others?” This sort of reflection increases emotional intelligence, where you understand how you respond to things based on how you receive and perceive them, and how you in turn bring that experience to the world around you in what you say and do. As far as barriers in developing emotional intelligence go, the biggest is to first recognize that it needs to be developed within oneself. Most of us go through our busy days, not consciously aware of how what we say or do is impacting those around us. The days go by, we meet our goals, and the rest often goes unseen and unheard, not because you’re actively trying to ignore what’s happening around you, but because you’re not necessarily paying attention.  Other barriers include access to coaches and programs which are either expensive or not created with the frontline healthcare provider experience taken into account. My online community addresses both barriers as a free community which addresses the cost barrier, and with content created and curated by me personally with my over 20 years of firsthand frontline experience as a surgeon, medical and surgical educator, author, senior academic and clinical leader, private practice owner, certified health executive, and certified emotional intelligence instructor.
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‍Any last pearls of wisdom for our readers?
A key thing to remember is that throughout your journey, you’ll have lots of challenges along the way and lots of successes along the way, both personally and professionally. The most important thing is not to get discouraged and to remember an impactful lesson I've learned in my life and career so far: Things often don't turn out as you plan or expect them, but in ways that you need to help you develop and grow.  If you're open to that, and you maintain a growth mindset along with a positive attitude, whatever challenges come your way, whether in academia, leadership, EDI, or anything else, you will find ways to meet these challenges successfully and learn important lessons that will benefit you in the future. Remember to ask for support and guidance when you need it and always remember that you're not alone. Feelings of stress and uncertainty are normal experiences we all face and can overcome with proper know-how, guidance and support.