Working Towards Equity in Surgery

18 Jun 2020

By Patricia Martinez Quiñones 

As a nation, we are facing the reality that systematic racism exists at all levels, affecting the communities we live in, the institutions we train in, and the patient populations we serve. The recent events, from the start of the COVID-19 pandemic and culminating with the tragic deaths of George Floyd, Breonna Taylor, Ahmaud Amery, to name a few, have highlighted how a lack of diversity can lead to situations such as these. Unfortunately, this is no different in the medical community, both for its practitioners and its patients. 

As we process our emotions and overwhelming frustration, we must acknowledge the marginalization endured by physicians who are underrepresented in medicine (URiM), the challenges of discrimination and exclusion that they face, and the obtacles overcomed by many URiM to become a physician, a surgeon, and a leader. In a nation with a diverse population, it has become an urgent priority that our physician workforce represent the patient population we serve. 

Encouraging diversity and inclusion, and striving for equity, in medicine and surgery begins by educating ourselves and our peers. In United States medical schools, women have reached parity with men; however, these gains of gender diversity among matriculating students have not been afforded to racial and ethnic minorities, especially Black and African Americans. Similarly, most surgical faculty are predominantly White and male. As of 2018, Black or African American and Latino or Hispanic surgeons only accounted for 7% of academic surgeons in the US

Diversity and inclusion is not limited to gender and race/ethnicity. Socioeconomic background, sexual orientation, cultural background, and religious beliefs must also be taken into consideration. Encouraging diversity and inclusion in these areas leads to diversity of thought and innovation and growth of departments, institutions, and organizations. While organizations like the Association of Women Surgeons (AWS), Association for Academic Surgery (AAS), Society of Black Academic Surgeons (SBAS), Latino Surgical Society (LSS), and Society of Asian Academic Surgeons (SAAS) are working to expand URiM in surgery, the question remains: As individuals and as a surgical community, how can we make surgery and surgical training equitable for all? 

Listen intently and keep an open mind. Reach out to your colleagues, trainees, and friends. Ask them about the challenges and difficulties that they may be facing. Inquire how you can help eliminate or lessen them. To become an ally and advocate, provide them with an opportunity to talk and express their emotions. Respect their right to share and not to share.

Reflect on your conscious and unconscious biases. Everyone has them.  Confront your biases and prejudices. Awareness of our own biases is the first step toward eradicating them. The Implicit Association Test is a great tool to measure your attitudes and beliefs, some of which you might not even be aware. 

When reviewing candidates for awards, promotions, and leadership positions, ensure URiM colleagues are not overlooked and nominate them or encourage them to apply. To increase inclusion and retention of URiM and, ultimately, reach equity, we must advocate and become allies for our peers and promote their advancement. If asked for speaker recommendations, panel discussants, candidates for awards, or leadership positions, consider your URiM colleagues and trainees. Volunteer to serve as their mentor and/or sponsor for that award application, grant submission, or letter of recommendation. 

Lastly, I encourage you to become a catalyst for change. Although we have made some progress in increasing awareness and developing initiatives to promote diversity and inclusion in surgery, we must strive for equity. Achieving equity is a collective endeavor. As the AWS motto–“Engage, Empower, Excel”–goes, we must Engage with those who possess a diversity of culture and thought and Empower URiM around us to achieve their goals, providing them with the necessary skills to Excel and flourish in their environment.

Patricia Martinez Quinones, MD, PhD, is a general surgery resident at the Medical College of Georgia at Augusta University. She plans to continue her career in academic trauma and critical care surgery. Patricia has served as the Chair for the AWS Resident and Fellow Committee and the AWS Blog Committee. She is a doggy-mom and wife who is passionate about promoting equity in healthcare, self-care, running, and healthy-living. You can find her on Twitter at @PMartinezMD.

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.

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