The career paths of successful surgeons are not always the same. Marwa A. Adi, M.D., FACS had to work harder to complete her training in ophthalmology, but her unique path has made her one of the most sought-after corneal specialists on the east coast.

Dr. Adi was born in Damascus, Syria. Her father, born and raised in Hana, was a general surgeon who trained in the U.S. and returned to Damascus to establish a hospital, which is still functioning today. Her mother was never allowed to pursue higher education, so she provided strong support to her daughter to pursue her academic dreams.

Her interest in ophthalmology began early. “I knew I wanted to be an ophthalmologist when I was 19 years old,” she said. “I was very attracted to the anatomy and physiology of the eye. I found the eye to be a fascinating and intriguing organ.”

After completing medical school at the University of Damascus, Dr. Adi came to the United States in 1981 and began her residency in ophthalmology in 1982 at George Washington University in the District of Columbia. The transition was difficult, but she said it helped her persevere.

As a medical graduate from another country, getting to ophthalmology training was harder and took longer for her than for students who studied in the U.S. However, she remained steadfast about specializing in ophthalmology. Initially, Dr. Adi completed an internship in general surgery, the back-up specialty she would have pursued in the event ophthalmology did not materialize. A year of research in ophthalmology followed before beginning her residency.

Looking back, she values her foundation in general surgery because it made her stand out. “I believe my surgical internship was important for developing the right disposition toward disease solving,” she explained. “The skills I received were very beneficial in my ophthalmology training. Most ophthalmologists do internal medicine, so general surgery helped me approach ophthalmology in a unique way.”

Setting High Goals

Even though Dr. Adi says she never had female physicians as mentors during her residency, her mother provided her with consistent support. “She was always facilitating the next step to help me advance in my career goals,” she said.

When Dr. Adi completed her ophthalmology fellowship, her mother asked, “What do you wish for your career?” Without hesitation, she said she wished to go into private practice with Melvin G. Alper, M.D., a renowned ophthalmic surgeon and neuro-ophthalmologist.

Dr. Alper ran a private practice, now called Washington Eye Physicians and Surgeons, and he was one of Dr. Adi’s clinical professors at George Washington University. Her dream of practicing with Dr. Alper felt too far-fetched to ever become a reality, but she and her mother never forgot this exchange.

For the next decade, Dr. Adi worked at a health maintenance organization (HMO) and in academia. One day, she received a call from the senior partner at the very same practice she once had said she wanted to join. The group was looking for an ophthalmologist with at least 10 years of experience specializing in the cornea. When Dr. Adi’s mother heard the news, she was ecstatic. Her daughter’s greatest hope was becoming a reality.

“Dr. Alper established Washington Eye Physicians and Surgeons in 1954. Fifty years later, in 1998, this practice had never hired a woman or a foreign graduate!” Dr. Adi exclaimed. “I told them, ‘If I join, I want to be a partner, not just an employee of this institution.’”

Having her colleagues recognize her expertise and commitment to patients was one thing, but Dr. Adi found that because she was in a traditionally male-dominated practice, the patients were a little surprised.

“Patients would ask, ‘Who will do the surgery? You?’ But they quickly understood that I was there to provide the highest quality of care, and now, because of the trust I have built with them and the progression of the medical field, I get referrals all the time,” she said.

“This October, I’ll celebrate 21 years of practicing ophthalmology at the medical group. We truly are a family and a part of the community.”

Her lesson, Dr. Adi whimsically said: “Hard work and determination truly pay off.”

Today, Dr. Adi can see how each segment of her career path played an integral role in developing her skillset, especially the years she worked in the HMO. “I encountered a great deal of complicated pathology in the HMO setting which forced me to depend on myself more. Those years were more formative, experience-wise, than I could have ever imagined. I am very satisfied with the course I took, but it also put me in a different category, and with my subspecialty experience, I became the expert on complex cases.”

Giving Back to the Community

When Dr. Adi is not seeing patients or performing surgery, she enjoys teaching at George Washington University/Medstar and mentoring young female physicians. It does not seem so long ago that she was the very first female cornea fellow at the University of Florida, so she is passionate about empowering women in her field.

“As an educator and someone who is involved in resident training, I try to give my female residents insight about their future careers, and I ask them what they want out of their practice.”

Dr. Adi and the physicians in her practice volunteer each month. They partner with residents to run glaucoma or cornea clinics and provide free or discounted procedures to community members.

According to Dr. Adi, mission work doesn’t have to require long flights. “All charity begins at home,” She said. In addition to caring for patients, Dr. Adi serves on the AMSURG Advisory Board, and she recently began her second term. “With ambulatory surgery centers across the U.S. and thousands of physician partners with different backgrounds and skills, AMSURG recognizes the importance of those different perspectives and experiences,” she said.

“The board is a reflection of the many patient populations we serve, and as a team, we are able to share and implement best practices so that we can continue to advance the delivery of care and improve the patient experience.”

“Their invitation for me to join the board was recognition that they wanted diversity and women,” she stated proudly. She hopes to be a good role model for young female physicians, especially her daughter, who is currently in medical school. Supportive mothers raise successful daughters.

“What really drives me, is the desire to help and be good,” Dr. Adi said. “Every day, I have the opportunity to make an impact on patients’ lives and in the careers of physicians newer to the field – and nothing is more rewarding.”

Geetanjali Akerkar, M.D., AGAF, describes herself as a compassionate healer, lifelong learner and strong advocate for her patients. A gastroenterologist who specializes in liver disease, inflammatory bowel disease and irritable bowel syndrome and a dedicated mother of three, Dr. Akerkar is the chief financial officer of Digestive Health Specialists and president of Lowell Anesthesia. She is also a founding member of Northeast Endoscopy and sits on the board of directors. Dr. Akerkar has an appointment at Harvard Medical School and serves on the board of the Massachusetts Gastroenterology Association. “Medicine allows me to utilize several strengths at once,” she said. “It requires quick analysis and interpersonal skills.” She is particularly passionate about gastroenterology (GI) because she treats patients of all ages and a diverse range of conditions including infections, autoimmune diseases and cancer. “I have to think of the whole body because symptoms could represent disease in other organ systems outside the GI tract.” In other words, gastroenterology keeps her on her toes. Excellence in GI Care Dr. Akerkar’s patients say she is a gifted communicator, a quality she honed many years ago while on the competitive debate team at Cornell University. “Patients tell me I explain things well and that I’m compassionate and direct,” she shared. These qualities are essential in a physician, especially when delivering difficult news like a cancer diagnosis. “My compassion gives patients hope, and the directness gives a sense of urgency to move forward with treatment.” Providing excellent care is one of many reasons Castle and Connolly named Dr. Akerkar a Boston Top Doctor for the third year in a row. This honor motivates her to offer cutting-edge technology to her patients. “Medicine and gastroenterology are moving targets,” Dr. Akerkar said. Ongoing training allows me to provide my patients with a wide variety of therapy options as well as the most current treatments.” Most recently, Dr. Akerkar trained to learn a procedure called Barrx, a new radiofrequency ablation treatment for Barrett’s esophagus. A strong advocate for her patients in the Greater Boston area, Dr. Akerkar explained, “My mission is to provide the best local care to my patients and the best access to tertiary centers. Because I’ve lived in Boston for 20 years, I have the connections to get patients with rare conditions to the right facility for complicated surgeries.” Being a Female Physician Leader Several women played a key role in mentoring and encouraging Dr. Akerkar on her path to becoming a female physician leader. Teresa Wright, M.D., head of liver disease at the University of California San Francisco and president of the American Association for the Study of Liver Diseases, mentored her as a GI fellow and invited her to co-write and publish. Doree Barton, M.D., founder of Digestive Health Specialists, provided an example of strong female leadership and dedication to quality patient care. Dr. Akerkar is currently the only female in her practice group, and she attributes the mutual respect among the physicians regardless of gender to Dr. Barton’s pioneering efforts on behalf of female physicians. Dr. Akerkar said she feels privileged to dedicate her time to support the professional growth of other female physician leaders. The American Gastroenterological Association hosted a Women’s Leadership Initiative, and Dr. Akerkar participated in its inaugural year by working collaboratively to improve gender equality and to foster sponsorship and mentorship among GI physicians. She recently accepted an invitation to serve on the President’s Council of Cornell Women where she will promote advancement of female faculty and students. Women are still underrepresented in gastroenterology and other procedural and surgical specialties, but Dr. Akerkar sees this as an advantage. “Many women shy away from procedural or surgical specialties because of the call schedule. While the training process is more rigorous, these fields seek women and therefore, present unique opportunities. Before she joined Digestive Health Specialists, Dr. Akerkar took time off to be at home with her twins until they were a year old. Because she was well-trained, she was confident in her ability to return to a full-time position. Her practice prioritizes family, and she has tried not to miss sports games and concerts. “I tell my female mentees, ‘If you have a passion for a specialty, go for it. When you are one of few, you actually have more control over your schedule.’” Young female physicians must be heeding her advice because women will comprise about half of the next generation of GI fellows. Dr. Akerkar is amused by the tangible evidence of this change – as she sees the line for the women’s restroom growing longer every year at annual GI meetings.

Nathalie C. Rioux, M.D., FRCS, is passionate about improving diversity in medicine.

“Women in Medicine Month means a great deal to me,” said Dr. Rioux, a fellowship-trained glaucoma specialist with Pioneer Valley Ophthalmic Consultants in Greenfield, Amherst and Holyoke, Massachusetts. “Females practice medicine a little differently because we have a unique touch.”

Born, raised and trained in Montreal, Canada, Dr. Rioux was not in the minority as a woman in medicine. “In 1991, my graduating class at the University of Montreal School of Medicine was 60 percent female and 40 percent male,” she proudly stated. “In my surgical subspecialty at the University of Montreal Affiliated Hospitals, we had equal numbers of men and women.”

When Dr. Rioux began her career in the United States, she experienced a culture shock. She was the only female in surgery, and her colleagues mistakenly thought she was a sales rep. “I think we still have a lot of work to do in the United States because we need more female doctors. I think males and females work well together because we complete each other,” she said.

Dr. Rioux runs a thriving practice with her partner, John P. Frangie, M.D., who is a corneal specialist. Their practice is the only one in Western Massachusetts with both a fellowship-trained glaucoma specialist and a fellowship-trained cornea specialist. Dr. Rioux is also married to an ophthalmologist, John A. Thayer, M.D., who is in private practice locally.

There are many necessary steps to improve diversity and inclusion in medicine. Dr. Rioux would like to see equal numbers of men and women accepted into medical schools, but this requires flourishing science, technology, engineering and mathematics (STEM) programs on the high school level. She advocates for STEM programs at Stoneleigh-Burnham School, an academically rigorous International Baccalaureate school in Greenfield. The school is comprised of students from 13 states and 11 countries and is committed to racial and socioeconomic diversity. As a member of their board of trustees, Dr. Rioux speaks at conferences to encourage young female high school students to pursue sciences. She tells the students, “Women are excellent surgeons. Talent is gender-neutral.”

She also mentors young female ophthalmology students, and she welcomes them to shadow her in the office and in surgery. Through mentoring, she provides practical clinical training as well as candid interpersonal advice about the pervasiveness of sexual harassment. She advises young female physicians, “Stand your ground and make it clear from the very beginning that you don’t accept harassment.” She gives the same advice to her daughter, Julia, a 19-year-old pre-law student at the University of Toronto.

As a glaucoma specialist and member of the board of directors at Pioneer Valley Ophthalmic Consultants, Dr. Rioux is committed to bringing innovations to the surgery center, “I was the one who initiated the purchase of the Selective Laser Trabeculoplasty (SLT) laser,” she remembered, “and because all the ophthalmologists used it, we paid for the laser within the year.” She has always tried to stay current with new surgical approaches like minimally invasive glaucoma surgery (MIGS) and new glaucoma devices that improve the quality of life in her patients.

It is essential for her as a female physician in leadership to stay up-to-speed clinically, but Dr. Rioux says nothing is more important to her than her relationship with people. “I am very close to the people I work with at the surgery center. I like to represent the employees, and I am a good voice for them.”

Empathy and kindness are two traits she learned from her grandfather, an OB-GYN in Quebec City who was her mentor. “The difference between a good doctor and a great doctor is the relationship you have with your patients. It’s not just what you know. It’s what you say and how you say it.”

It is not common these days to meet an individual who has worked with the same company for 30 years. Cindy Sease, registered nurse, is not your common center leader. She has worked at the Columbia Gastrointestinal Endoscopy Center since the doors first opened in November 1988. “Working for the same center has allowed me the opportunity to master my job. That doesn’t mean I don’t make mistakes. It means that I have had the time to learn, experience and continue to grow in my field, which makes me enjoy and appreciate the work I do.”

Cindy has been a mainstay at the Columbia GI Center, working with a variety of physicians and staff throughout the years. This includes AMSURG’s Medical Director John Popp, Jr. M.D. “When I attended center leader orientation, I was amazed at the number of roles, sometimes duties outside the scope of their work; they play to keep our centers operating efficiently. Our center has been incredibly fortunate to have Cindy at the helm since the day we opened. Cindy has demonstrated a level of professionalism and commitment throughout her years at Columbia and Lake Murray and has been an integral part of the success of the centers,” said Popp. “I congratulate and applaud Cindy on 30 years of dedicated service. Thank you for all you have done and continue to do.”

Cindy began her nursing career in 1981 at a large teaching hospital in Columbia South Carolina, Richland Memorial Hospital. “I began working on a Medical-Surgical floor which was also the cancer treatment and dialysis floor,” explained Cindy. “The patients were very sick. But, the nursing staff was very caring and took me in as a new nurse. After some training, I was on my own. I loved the job.”

Two years later, Cindy transferred to the GI lab. “Back in 1983 screening colonoscopies were not being performed routinely, so we found a lot of cancers; colon cancer and gastric cancers. It felt good to know I was a part of a team that was helping those with cancer,” Cindy said. “With my oncology background, I felt I was able to offer some hope and comfort to those receiving such a diagnosis. Cancer treatment was making great advancements during this time.”

In 1988, Columbia Gastrointestinal Endoscopy Center opened and was one of the first ambulatory surgical centers in South Carolina.  “I was proud to assist in the very first procedure. I remember everyone being somewhat nervous, but we broke the ice and here we are 30 years later,” Cindy exclaimed.

When asked about the most memorable changes she has seen over her 30-year career, Cindy replied, “The biggest improvements over the years have been in reprocessing and infection control. When I began in GI, we reprocessed using betadine solution and alcohol. The scopes were fiber optic and the doctor looked through an eye piece. Some of the scopes had a joy stick knob, not the customary turn dial like today. Stretchers were hand-cranked, not hydraulic, and wheelchairs were wooden, but rolled like a dream! I was in my 20s and living a dream.”

Just as the center grew and changed, so did Cindy’s personal life. “There have been many changes over the 30 years.  During this time, I married my husband of 35 years, Robby, and we had two boys, Bobby and David,” Cindy said. “We also had many changes in the center. There were three small remodels at Columbia Main as we grew.  In 2003, we completed a remodel of the Columbia Center and we opened our second facility, Lake Murray Endoscopy Center. I’ve seen many doctors come and go and staff members too.”

Cindy credits the dedicated staff at Columbia GI as one of the main reasons she has and many others have stayed at the center. “I have several long term employees… Sandra Russell our clinical manager at Lake Murray Endoscopy Center has been with us for 24 years. Marianne Hill, past RN manager at Columbia, has been with us for 20 years. Margaret Danko, RN, has 16 years at Columbia. Debbie Braxton, Cynthia Green and Cheri Foster have been with us for 15+ years,” explained Cindy. “We have always tried to be upbeat and have a good time at work; I think this says a lot about our Center, our team, and its culture.”

Managing two centers, Cindy’s responsibilities have increased over the years. “From assisting with procedures, which I still do when needed, to training, payroll, anesthesia coordination and accounts payable, risk management, human resources and much, much more, can be quite a feat. But the one that has evolved the most, is QAPI [Quality Assurance and Performance Improvement],” Cindy said.

Cindy may not be planning for another 30 years but she expects to remain a part of the center for a few more years before retirement. In the meantime, she is continuing to enjoy her work as well as her hobbies outside of the center—knitting, crocheting and gardening. She loves spending quality time with her family and friends at the lake or beach, and especially the time with her three grandsons, Cooper, Tanner and Waylon.

Congratulations and thank you for 30 years of service, Cindy.