Interview with Professor Fiona Wood
International Women’s Day (IWD) on 8 March 2023 celebrates the social, economic, cultural and environmental achievements of women around the world. The day also marks a call to action for accelerating gender parity. Medical Technology Association of Australia reached out to trailblazers and inspiring female leaders in MedTech. It’s an opportunity to showcase outstanding female individuals for their contributions who advance gender equality, promote the current UN IWD theme, and/or advancing MedTech forward.
As part of this, MTAA has asked Professor Fiona Wood to speak about gender equality, her innovation of the ‘spray-on skin’ technique, and her accomplishments as a surgeon and researcher for over 30 years.
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This year’s International Women’s Day Theme is ‘Crack the Code: Innovation for a gender-equal future’. It’s about embracing technology and championing the unique skills and knowledge of women in STEM and progressing towards a gender-equal future. What does this mean to you?
I think when we look forward to tomorrow and think, you know, that we could have a gender-equal future based on technology and science and innovation, it's exciting. But the first step along that road, which we've been travelling for some time, is understanding the need to do better. Understanding that today is a point where we learn a point where we take stock and reflect on what we've achieved. But it's not a place to be complacent. I think the first step in every journey is understanding the need to move, understanding the need for us to continue to work in this space, and understanding the opportunities. So it's charting the course and then getting us rolling our sleeves up, getting the boots on and moving forward. And you know, like any journey where the more we take part, the more we share the load. And so I think collaboration is key, not just, for females, but across the whole of our community because, if we want a gender-equal future, then it has to be equal. So being part of that journey on both sides of the fence, if you like, is really important.
How important is it to consider gender diversity in the patient population for clinical trials and product development?
I think one of the problems when we look back and understand, is that a lot of the clinical trials are adult males, and, well, we've got to start thinking about something beyond that because, we certainly in our space in looking at scarring, for example, post-burn injury, we know that those scars are influenced by many different factors including age, sex, genetic, makeup. So the level of pigmentation in your skin actually profoundly affects the scarring. When we are looking at scar therapies, then our clinical trials should actually encompass that. I am an absolute believer that we have to stand back from what we've done traditionally and understand, yes, that's a great starting point. Fine. However, if we want to answer the question and really engage the technology for the benefit of everyone, then we have to look at how we test the technology in everyone. And so diversity is absolutely a fundamental cornerstone of that process going forward.
When developing the spray-on skin technology, were there any significant gender bias hurdles that you needed to overcome?
The sprayer skin technology started for me in the 1980s and certainly in the early 1990s when I met Marie Stoner. We sort of hit the ground running, looking at the technology of the time and looking at how we could build on that and make something much more useful in terms of time to utilization, cost, and convenience and all those different things that we put on the table as problems of growing skin. And so how can we address those problems? And when I think about gender bias in that context, well, there were two young women who are successful in our endeavour and things look easy. However, at the time, there were the hurdles of being a woman in surgery. There were the hurdles of being a woman in science. There were the hurdles of being a woman in business and being women in business. And so I think like many things, if you pay too much attention, you give it too much oxygen. We spent a lot of time almost blinking ourselves and just kept focused. We were focused on the end goal and that was to build a medical device that was for point-of-care harvesting of skin cells. That was our goal. That was our ultimate aim. And so when we came across things that are barriers to that were either, gender bias or not, then we had two choices: Do we turn to divert our attention and deal with that problem or do we turn and look where we were, find a place where we supported and a place where we could actually progress to our aim? And I think it's a pain. You know, there are always going to be negatives. There are always going to be hurdles, but you have to step back from that hurdle and look, do you wanna knock it down or do you wanna walk around it? And that both of them take energy, both of them take time. But I'll put it to you that sometimes engaging with negative energy without the possibility of a positive outcome is actually a waste of absolute resource. And the most precious resource you have is your time. And so we were very judicious about where we spent our time and energy. And, if someone didn't want to support us or, for whatever reason, we just walked on by. And I think negative energy without engagement in problem-solving deserves no oxygen, so walk on by. There are plenty of people, there are plenty of good people in this world. And connecting with those good people builds positive energy. And that's the space to go. That's the space to drive to.
Gender bias could also be fed by the lack of female representation in some surgical specialties. As a pioneer in the surgical space, how do you feel we can impact change?
I think there is [gender bias] in medicine, certainly, when I went to medical school I was one of 12 women in my year. When my daughter went to medical school, there was 52% female. But that doesn't mean to say we've actually cracked the whole problem, because certainly, as we go forward moving into spaces where, there it is traditionally more male orientated, I think it is something we have to pay attention to. I know many female surgeons who are excellent people as well as men. But what we have to think about is making people believe.
I'll tell a story because some years ago, one of my children's partners was in med school, and she'd come back quite distressed because they'd had a talk to their surgical interest group. So a group of medical students who were interested in surgery, and there were males or females in the room, and a male and female came to speak with them about careers in surgery. And so, the culmination of this was that if you were a female, you had to really be considerate of whether you wanted a family or not, because, you know, there were difficulties in that regard with respect to the austerity, if you like, of the surgical training program. Well, I haven't heard this. I thought this can't be real, this is wrong, right? You might have your opinion, but that's what it is. But does it make it fact? Hmm, I don't think so. So I rang the dean and I said, "you probably don't know me, but I'll want to come and speak to your medical students in the surgical interest group."
So I went in, I said "Hi, I'm a surgeon and my husband's a surgeon too. We have six children. So you understand, unless you're prepared to have six children, you won't have a career in surgery." At which point everybody left. And then I said, "well when somebody came here and told you the opposite, why did you believe them?" So part of this whole problem is belief and self-belief. There are enough role models there that you can choose and you can choose to believe whoever you like, of course. But I think it's really important is that we don't put our biases or our beliefs and push them down onto our younger people. We give them the opportunity to be the best, be the best version of themselves and to express themselves. That's what our role is as older people, not to go, well, I did it this way, you'll do it that way. And, so for me, it's facilitating of people to reach their potential. And that underpins this whole problem.
Looking at things from an innovator’s lens, what do you believe was a key technological factor which led to the success of the spray-on skin?
The spray your skin story, well, the question sort of indicates the success and in my mind, is it successful yet was my first thought, because it's a journey and it's always trying to work out how to do it better. And so I think if I stand back from that and reflect, that's the key. It's always trying to improve, always understanding the nuance, the marginal gain, the big gain. Certainly, in the early days of driving the traditional technologies, understanding that there is a need to do better understanding, there is a need to interrogate and investigate the scarring process, which, you know, has a profound effect, not just locally in the area of the skin, but systemically throughout the whole body. And so understanding these things means that you're always driving to get better.
Certainly, with the Brown skin story, we are looking at 3D printing of a framework such that when the cells are into the framework, they express themselves to make the appropriate tissue, which is skin. And so there's lots of research that's ongoing. So, from an innovator's lens, I think you're in charge with the responsibility of improving and developing improvements in your chosen field. And that's my privilege. It's my responsibility. I think, you know, the education and training I have, you have to think about, well, how can you give back? And how can you use that intellect to improve our current treatments and invent new ones? And it's always about being curious, always understanding, and the importance of asking why, why has that happened? Why, why would it have worked out that way? What can we do that could change that? And so curiosity underpins it and the need to do better, as I've said before, and, and the collaboration to, to connect that energy and drive with positivity.
And so, is it a success story? And I'm not so sure, but we are still working on it. Yeah, I know it's used and it used around the world helping many thousands of people. Certainly, we've, almost treated almost 5,000 people here now in Western Australia. But we've been at this for 20-odd years. And so how can it be, how do you make sure your innovation is a success is by remaining curious about it all the way through and understanding the challenges of implementation, the challenges of the systems that we work in, whether it be regulation, finance, and then the education and training program to ensure that the innovation is used appropriately, and in the right patient, be the right patient, the right time with the right therapy is so fundamentally important. So there are lots to this, but it's exciting.
How can we better support Australian clinical trial developments and expand innovative technologies locally?
I think with respect to innovation and clinical trials, as a country, we have to understand that by being at the table and actively innovating and actively undertaking clinical trials, then the cost of that innovation and the cost of other innovations coming in changes. If we are just a passive recipient to innovation from the rest of the world, it'll, it will cost us on many, many different levels. And so being part of the 'tomorrow' brings benefits that are much more far-reaching.
The fundamental importance of actually developing systems such that the intellectual capacity of Australian minds can be utilised is a fundamental importance.
What do we produce? Well, we can produce things out of the ground and we can produce our agriculture, but we can also produce significant innovation with the intellectual capacity, not just in health across the board with those Australian minds, but we have to have the frameworks in place to facilitate the best in those minds. And, you know, the clinical trials framework is one of those fundamental building blocks, absolutely unquestioned. Having the capacity to develop vaccines onshore is actually fundamental. Having the capacity to develop stem cells or whatever other biologic innovation, and having homegrown pharmaceutical capacity. Now, all these things really matter. If we really truly want to capitalise on the education and training of all our children this will come through.
You co-founded the Fiona Wood Foundation, formerly the McComb Foundation, in 1999. Tell us more about the Foundation's work and how it started?
One of the things about research is the funding, of course, and the research and innovation that goes with it. Where'd you get the money to start and to get enough momentum so it can't be stopped.
Many, many years ago, almost 30 years ago now, Maria and I started a not-for-profit foundation. There was the McComb Foundation and now renamed the Fiona Wood Foundation changed by my colleagues. It has given us the capacity to continue our research between the lean times when the competitive grants don't come through, but it's also given us the opportunity for our community to be part of our journey with us. And so we have philanthropy, we have corporate support, and it has also given us the opportunity to invest our intellectual property. I assigned my intellectual property to the foundation over 20 years ago for the spray on skin. This is my motivation - to make the technology available to people across the world and also to continue our research. The royalties go into the Foundation. And so all these things give us the capacity to grow the Fiona Foundation so that our research is sustainable into the future. It is a fundamental building block of the system we work in.
I work in the university, I work in the health department, and we work with the foundation so that people around us can be part of our journey. Sometimes our patients, sometimes those who care for our patients, and sometimes people who just care. And that's given us a great opportunity, as they say, to keep the research going. And certainly from my perspective, assigning intellectual property, assigning book rights, all these things will keep it sustainable into the future.
Where do you think female surgical leadership can take innovation as we look to the future? Alternatively, where do you think more diverse gender balance leadership can take us as we look to the future of surgical innovation?
The Royal College of Surgeons has now got a section dedicated to innovation. I think it's interesting that that's a risen when the president of the Royal College of Surgeons is a woman. But that's not to say that when I was in Sydney, just towards the end of last year in a specific workshop joining the dots, there were both men and women, those people who are innovating, those people who are trying to make surgery better for all of us, were in the room. And it was vibrant, it was exciting, but for me, it was particularly exciting that it was happening at all. Surgeons, you know, could be argued to be conservative with good reason. However, there's the capacity to harness science and technology and bring to bear change at the coal phase is enormous. And so I think the, there's a role for all of us, and I think, as I said right at the beginning, the first step is understanding the need to do better. And,I think it's interesting that it was when a woman was president.
