By Nickey Jafari
Earlier this year, an attending surgeon commented that my AWS fleece was “sexist”. I highlighted the number of female surgical department chairs (16) as one example of why promoting women in surgery is still critical. He responded that the numbers were so vastly unequal because “women don’t want to be department chairs.”
I then told him about the AWS conference in D.C., where I was surrounded by titans of surgery. Yes, they were also women– a fact that should not negate their accomplishments. I told him about Dr. Patricia Numann, a former President of the American College of Surgeons, and founder of AWS. He could not be swayed to recognize women who wanted to visibly lead within surgery, who have earned the benchmarks typically meeting those of men in similar or superior positions. A surgeon who I greatly admire put it more eloquently than I myself could: “There is no inherent racism/sexism/discrimination in the promotion of an underrepresented group because it is by definition underrepresented and does not have the social or political power to systematically discriminate against those who are.” It will be an uphill battle to convince those who do not see the gender inequity within surgery from training to leadership, but we can continue to be armed with new studies and hard facts to aid us in this discussion.
While women make up half of medical school students, they still are around one-third of practicing physicians and lag behind in both pay and promotion. A recent JAMA study of over 10,000 academic physicians found significant disparities in compensation across medical specialties. “Female neurosurgeons and cardiothoracic surgeons and women in other surgical subspecialties made roughly $44,000 less than comparable men in those fields.” These differences in pay exist even after researchers corrected for factors such as age, experience, faculty rank, and specialty. Equal pay for equal work is as logical of a demand as ever, but these pay disparities become an even tougher pill to swallow considering another recent JAMA study demonstrating patient outcomes were better when the treating physician was a female internist. It concluded that “approximately 32,000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year.” Until healthcare centers recognize the strengths diversity brings to the care delivered to patients, our ability to optimize patient outcomes will continue to be compromised.
Nickey Jafari is a third year medical student at the University of Kansas. She is interested in surgery and hopes to find a niche where that interest can intersect with her passion for global health.
Thank you Nickey for succinctly describing one of the contributors to the worldwide surgical workforce shortage-not promoting equally worthy women to positions of leadership-or compensating them appropriately!
Nickey, your post (and your attending’s comment) served to help me double down on gratitude for the “enlightened men” who have mentored and sponsored me throughout my career, and those whom I have watched do that for others.
It’s my deepest hope that by the time you are out of training we’ll have moved our profession further towards being a meritocracy.
Thanks Nickey for a great read! There are most certainly equality issues in surgery, which are admittedly improving, but still need more work. Men who don’t realize this are becoming the minority, so some of this will correct with time, but we can correct it faster with action.
And even so, what happens when we get to 50/50 and pay equity? Will AWS just poof! and cease to exist? Of course not. Organizations can be about differences and not disparity. The very experience of being a woman surgeon is simply different than being a man, and we will continue to explore this and support one another, even when we reach a meritocracy.
Thank you Nickey for contributing to this extremely important discussion.
In developing countries, the cases of pay disparities are even more frequent, and the pay differences can be greater. For this reason, it is important to raise awareness in all different surgical settings and environments, and to encourage organizations such as AWS where women in surgery can support one another.