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Member Spotlight: Dr. Regina Fragneto on Women in Leadership, High-Impact Journal Articles, and the Future of Virtual Recruitment

  
Nominated by @Mary Gibbons, MD: “Of the three women residents I knew in residency, I went to Columbia for a cardiac fellowship, my co-chief went to a critical care fellowship, and the third went to a pediatrician cardiac fellowship. Other attendings told me I didn’t need a fellowship, but Dr. Fragneto encouraged me to apply to the top fellowships in the country. She has served as an inspiring mentor to women in Anesthesia and always maintains the highest academic standards.”

(Is there an ASA member you'd like to nominate for a Spotlight? Tell us here.)

As Director of resident recruitment for the University of Kentucky, you’ve had to make significant changes to your typical process this year. How are you handling resident recruitment in the days of COVID, and do you think these adjustments will have a lasting impact on your program?

It’s kind of funny that you asked this question because actually I decided during last year’s recruitment season that after nearly 20 years of leading this effort in our department, I would pass this role on to someone else for the 2020/21 season. To be clear, I made this decision well before COVID appeared so I was not bailing out of a difficult recruitment season. I did (somewhat jokingly) tell my husband that my timing was perfect. I have watched with admiration, though, as our recruitment team has done a phenomenal job adapting to a completely virtual recruitment experience.

Such an important part of the recruitment process for resident applicants is determining if the department’s personality is a good fit for them. That is really tough to ascertain without an in-person visit, but I am impressed with how our team has leveraged technology to provide virtual open houses and discussion sessions with residents. I was fortunate to participate in one of our virtual interview days a couple weeks ago and I did feel like I still got to know the applicants during our interviews. Another interviewer mentioned that they felt like the applicants weren’t as nervous as during in-person interviews. And that kind of makes sense. We’ve all had the experience of sitting in a room with someone who could significantly impact your career trajectory and know how anxiety provoking that can be. If interviewing in a virtual environment leads to less anxiety, that can be beneficial to everyone. The applicant can more readily focus on learning about the department’s people and program and we, as interviewers, can more easily assess an applicant’s personality when they are not so anxious.

I’m not sure how this virtual recruitment season is going to ultimately impact programs’ recruitment processes. I do think an in-person visit is extremely valuable, but there is no question that there are definite advantages to the current process for applicants, especially in terms of time commitment and travel expenses. I hope we can ultimately get to some sort of hybrid approach that can balance all the needs and goals of applicants and programs.

How do you encourage your women residents in a still largely male-dominated specialty?

I think it is important for our women residents to see what is possible in our specialty, and medicine in general, despite this being a male-dominated field. And probably the best way to do that is through role modeling and providing resources to help them reach their career goals.

We are fortunate at the University of Kentucky to have a thriving Women in Medicine and Science (WIMS) organization that provides some of those resources and support. I serve on the organization’s Executive Committee, and through this group I have found valuable networking opportunities outside my department. Several of the WIMS programs provide all participants, including trainees, the opportunity to develop skills that will help them with career advancement and ultimately the ability to succeed as a leader. The need for such programs in medicine and anesthesiology is great, I believe. Our WIMS program began offering a Professional Development certificate program last year, and we already have had nearly 100 students, trainees, and junior faculty participate.

It is also important for our women residents to see their mentors succeed as it gives them hope and the motivation to strive towards their own goals. And we are fortunate to be able to showcase for our current women residents several such role models in past University of Kentucky residents. These include Dr. Annette Rebel, our department’s residency program director and Vice Chair for Education, Dr. Aru Reddy, who is now Chief of Anesthesia at Arkansas Children’s Hospital, and Dr. Rosalind Ritchie, a member of the SAMBA Board of Directors and President of the UK College of Medicine’s Faculty of Color Network. I am very proud of these women and hope I have helped them in some way in their career development just as I want to help all our residents, women and men, as they explore and develop their career goals.


You currently serve on three ASA committees: the Committee on Obstetric Anesthesia, the Committee on Professional Diversity, and the Committee on Women Anesthesiologists. What trends or key takeaways are you seeing at the intersection of these three areas? What have been the biggest changes you’ve seen in the practice of anesthesiology as it relates to women (physicians and patients) and diversity of background and personal experience?

I am extremely fortunate to have been named to these committees because they truly represent my professional passions. Clinically, obstetric anesthesia is what I love to do and teach. Outside of my clinical practice at the University of Kentucky, my focus most recently has been in the area of diversity, equity and inclusion (DEI). In addition to my involvement in WIMS, I am our department’s DEI representative for the College of Medicine.

I would say a key goal for all three areas right now is striving to achieve equity. Obstetric anesthesiologists have both the skills and a duty to contribute to national efforts to improve our maternal mortality ratio, which is truly abysmal for a developed country. And especially concerning is the disparity in maternal mortality among different racial groups, particularly the much higher rate in Black women. It goes without saying that working towards equity is a major focus and goal of both the Committee on Professional Diversity and the Committee on Women Anesthesiologists. There is much work to be done, but with such talented members of these committees I am certain progress will be made.

And let’s celebrate the accomplishments that have been achieved by the ASA. We are now in our third consecutive year of our society being led by a woman President. That is unprecedented! But we also must not forget that there is still much work to be done. We have not been nearly as successful in placing anesthesiologists of color into senior leadership positions within ASA. And while I am very excited about our three recent women Presidents, when I look at the current leadership pipeline there is a dearth of both women and people of color.

You’re also President of the Kentucky Society of Anesthesiologists. How do you see the state components’ role in supporting its members and moving the specialty forward?

State component societies are crucial both to their members and the ASA. While we do face some common challenges nationally for which ASA’s efforts are invaluable, there are also several unique local issues that must be addressed and it is the state societies, with their local connections, that are most effective in tackling these challenges and achieving solutions. That being said, the many resources provided by ASA to their component societies are essential to our success in addressing state-level issues.

As Editor-in-Chief of the journal Obstetric Anesthesia Digest and member of the editorial board of the Journal of Clinical Anesthesia, you have an insider’s view of journal publishing. What do you think are the key aspects of a truly impactful journal article?

For the majority of anesthesiologists, the most impactful journal articles are going to be those that will actually change our practice, either now or in the future. Over the past few years, under the leadership of our Editor-in-Chief, Dr. Gil De Oliveira, Journal of Clinical Anesthesia has seen a significant rise in its impact factor. I believe that is due to the fact that we do focus on the clinical importance of an article when making publication decisions. Of course, this is not meant to minimize the importance of basic science articles. In fact, future changes and advances in practice are dependent on the discoveries coming from this important research. Obstetric Anesthesia Digest, of which I have been a co-Editor-in-Chief for nearly 10 years is a unique journal; we don’t publish original research but rather provide summaries of what myself and the other co-Editors-in-Chief believe have been the most relevant articles to obstetric anesthesiologists published over the past year. Commentaries from international experts accompany several of the summaries, and they emphasize another important aspect of any impactful article – rigorous study design, statistical analysis, and interpretation of results. This journal was founded 40 years ago by Dr. Gertie Marx, who most of us within our subspecialty refer to as the Grandmother of Obstetric Anesthesiology. I’m proud to say that over the past few years, we have had an all-women group of co-Editors-in-Chief. It’s been a privilege to work with Dr. Emily Sharpe and Dr. Trish Dalby to produce this journal. And in 2021 another talented woman, Dr. Rachel Kacmar, is assuming my position as I conclude my time as an Editor-in-Chief.

Is there anything you’d like to discuss that we haven’t talked about?

To be successful in our careers we all need allies who help us along the way. I would like to acknowledge two people who have been instrumental in helping me achieve my professional goals. My first contributions to ASA were through my involvement in the SEE and ACE CME programs, and Dr. Ned Bowe was responsible for getting me involved in both of those activities. I served on the editorial board for both and then ultimately became Editor-in-Chief of the SEE program. I do believe my involvement in both those programs, and especially SEE, have been the ASA activities most impactful to me, both professionally and personally. The question writers and editors of SEE and ACE truly are unsung heroes of the ASA, tirelessly dedicating hundreds of hours of their time to produce high quality CME for ASA members. Through my participation in these programs, I learned so much from experts in every anesthesiology subspecialty. Even more importantly to me on a personal level is that I developed amazing relationships with colleagues from all over the country. Some of my best friends in anesthesiology are people I served with on the editorial board, and these are friendships that I know will last a lifetime. Dr. Bob Gaiser has been my friend and ally within Obstetric Anesthesiology ever since we worked together during my fellowship at Brigham and Women’s Hospital. As a leader in our subspecialty, he has provided me with so many opportunities in our field at the national level. He truly is the epitome of a servant leader. One of the highlights of my career has been receiving the SOAP Teacher of the Year Award, and Bob was the person responsible for my nomination. Our society is fortunate to have so many dedicated people willing to give of their time and talent to our specialty and patients, and I have been extremely lucky throughout my career to benefit from the assistance and contributions of so many of them. Finally, I want to extend a very special thank you to Dr. Mary Beth Gibbons, one of our former chief residents at the University of Kentucky, who nominated me for this member spotlight. 

Regina Fragneto, MD, FASA, is the Editor-in-Chief of the journal Obstetric Anesthesia Digest and serves on the editorial board of the Journal of Clinical Anesthesia. She is a member of the American Society of Anesthesiologists Committee on Obstetric Anesthesia and is President of the Kentucky Society of Anesthesiologists.

Dr. Fragneto is a Professor of Anesthesiology and serves as the Division Chief in Obstetric Anesthesia at the University of Kentucky College of Medicine. She previously served as the school's director of resident recruitment. 

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ASA Community Blog is published as a benefit for ASA members. The views expressed on this blog are those of the individual contributing writers only and do not necessarily represent the opinions of ASA.

Comments

Lawrence KilinskiJr
Dec 22, 2020 12:09 PM

Dr. Fragneto was a positive influence and dedicated teacher for all residents.  Thank you Regina for making me a better person and anesthesiologist.

Larry Kilinski, PharmD, MD

President-elect Deaconess Hospital Medical Staff

Assistant Professor of Clinical Anesthesia - IU School of Medicine

Anesthesiologist - Evansville IN

James Mesrobian
Dec 20, 2020 09:18 AM

Super article and profile.  Thanks, Regina, for your dedication to our specialty!  

Elizabeth Foxx
Dec 11, 2020 07:32 AM

Regina Fragneto was one of my attending at MCV/VCU and I will never forget her. She loved what she did and taught us with passion. I’m so glad to see her spotlighted here as she is so deserving. Thank you Regina!! 

Elizabeth Foxx, MD