Diversity and Inclusion in Surgery

14 Feb 2021

By Yewande Alimi

 As we progress through the month of February, the month also dedicated to Black History, I reflect on the notion of diversity and inclusion in the field of surgery. After the gut-wrenching year of 2020 that laid to bear a once in a lifetime pandemic that continues to ravage the world at large and the civil unrest that towered throughout the United States, it’s important that we acknowledge the need for practitioners, allies, administrators, and leaders that look like the composition of the world that we live in. That we are in 2021, and that academic black surgeons only comprise 2.7% of all academic surgeons, and that we have yet to reach parity when we look at black academic female surgeons in the field of medicine (0.78% vs 1.93%) is disappointing.

The United States is comprised of 12.8% African Americans, 18.4% Hispanic, yet they remain substantially underrepresented in the house of surgery (4.2%, 3.4%; respectively). When we dive even further and look at these numbers in surgery and surgical subspecialties, we continue to fall short. This isn’t just a numbers game in which one is simply trying to make the numbers match up for the sake of equality. This lack of diversity is important because it impacts the way in which our patients interact with the field of medicine.  While data is mixed regarding gender and racial concordance and resultant patient satisfaction and outcomes, it has been demonstrated that racial concordance between patient and physician improves outcomes in the domains of satisfaction and partnership building, which we can all agree can help our patients navigate the confusing world of healthcare better.   

 However, our problem does not lie alone in the fact that the numbers are not reflective of the US population. While efforts are being made to increase the number of under-represented minorities matriculation into medicine and strengthening the medical URM pipeline, our faucets are also leaking. Under-represented Black and Hispanic physicians and women are leaving the field of medicine due to pervasive and structural racism that exist in a system that is reflected by the lack of equitable promotion of these physician cohorts and in some from the sense of not belonging and isolation resulting in burnout. The field of medicine, and I dare say the house of surgery has work to do to help dismantle this system. These efforts begin in allyship and understanding of the lived experiences of under-represented trainees, faculty, and staff. We cannot dare to fix something that we fail to truly understand. Creating spaces for people to report, share, and document their experiences without retaliation or shame is important.  Our efforts must be grounded in evaluation of the state of affairs in our institutions (including within our societies, our training institutions, and as individuals), creating just and equitable work places, focusing on educating trainees and established faculty to be culturally competent and anti-racist, and by being true champions of diversity supporting research focused on addressing racism and its elimination.

 Finally, these efforts must not be solely undertaken by the very faculty, physicians, and trainees who are at risk of being marginalized. We must ALL embrace this burden and dedicate time and resources to create an impactful change.

 

Please join us on Monday, Feb. 15th at 8pm Eastern Standard Time for an AWS Tweetchat about diversity and inclusion in surgery, in partnership with the LSS!  This chat will focus on how to increase diversity in surgery, cultivate inclusive environments for all in surgical training, and how to get involved in diversity and inclusion initiatives within surgical societies and institutions.  The chat will be moderated by Dr. Yewande Alimi (@YewandeAlimiMD), Dr. Chantal Reyna (@kprgrl3), and Dr. Madeline Torres (@MadelineBTorres). The questions will be posted directly from the @WomenSurgeons twitter account and you can also find them following the hashtag #AWSchat. If you haven’t participated in a tweetchat with us before, check out this tutorial written by Dr. Heather Yeo (@heatheryeomd) to know more. We will be discussing the following topics during our tweetchat:

  • Q1: What are current barriers to increasing diversity and inclusion in surgery? 
  • Q2: What are some concrete ways that residencies and medical schools can increase the diversity in their programs and create inclusive, welcoming environments for all? 
  • Q3: What are some ways for trainees from URM backgrounds to build communities within their programs? Are there national organizations, committees, working groups, etc that you recommend? 
  • Q4: How can we all be allies for those who identify as URM?  Any specific examples from your programs?
  • Q5: How can we encourage URM students – from high school through medical school – to pursue medical and surgical careers? Are you involved in any unique volunteer or outreach initiatives?

Dr. Alimi is the current MIS & Bariatric surgery fellow at Stanford University. Originally from Nigeria, Yewande obtained her Bachelor’s  in biomedical engineering at Washington University in St. Louis, and went on to complete her medical degree in Atlanta at Emory University School of Medicine. Dr. Alimi completed residency in General Surgery at Georgetown University Hospital in Washington DC, where she was an active member in American College of Surgeons, currently serving as the Vice-Chair of the Resident and Associate Society and the Society of Black Academic Surgeons where she currently serves on the informatics and program committee. Her research interests include outcomes in bariatric surgery, healthcare disparities, and diversity and equity in healthcare. You can find her on SoMe @YewandeAlimiMD.


 

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

One Reply to “Diversity and Inclusion in Surgery”

  1. While evidence-based data for targeted interventions to mediate the gender achievement gap in surgery are sparse, the effort to promote gender equity is not. In recent years, the media, surgical societies and leaders within surgery have given considerable attention to developing strategies to close the gender achievement gap. For example, several prominent national surgical societies such as the American Surgical Association and the Society of Surgical Chairs have publicly committed to improving the representation of women in the national ranks through committee appointments and the assurance of gender balanced speaker panels. Additionally, the Association of Women Surgeons continues to address the unique challenges women face related to work life integration, pay equity and promotion through systematic mentoring programs,  resources such as their pay equity toolkit and policy statements  tackling the critical issue of sexual harassment. On a local level, institutions are also participating in diversifying the optics of who belongs in medicine and surgery. Recently,  Brigham and Women’s Hospital  removed 31 portraits of white male leaders in an effort to better reflect the diversity of their current environment.  Despite these efforts, a tremendous opportunity remains to study the gender achievement gap in order to develop, disseminate and study evidence-based interventions to eliminate gender inequity in surgery.

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