Leading by Example: Pioneering Women Chairs of Surgery in the Bay Area

By Hillary Braun and Marissa Boeck

Impressively, Stanford University, University of California, Davis (UCD), and University of California, San Francisco (UCSF) all currently have female chairs of surgery. These three women make up 14% of the 21 female surgery chairs present nationwide. As the Bay Area prepares to host the annual meetings of both the Association of Women Surgeons (AWS) and the American College of Surgeons (ACS) at the end of October, there seems to be no better time than now to honor and highlight this powerful trio of American surgeons who are breaking barriers and advancing the surgical leadership landscape.

The story of women in surgical leadership in the Bay Area begins with Dr. Nancy Ascher, who became Chair of Surgery at UCSF in 1999, making her one of just four female chairs in the United States at the time. A world-renowned transplant surgeon, revered for her sharp clinical acumen and technical prowess in the operating room, Dr. Ascher led UCSF by example from 1999-2016. During this time, she also grew the Department into an oasis for female surgeons, with women currently representing more than 30% of the faculty and over 50% of the trainees in the surgical residency.

In 2018, Dr. Julie Ann Sosa became Chair of Surgery at UCSF, making her the first woman to succeed another female chair of surgery in the country. She joined the local company of Dr. Diana Farmer, Chair of Surgery at UCD since 2011, and Dr. Mary Hawn, who was named Chair of Surgery at Stanford in 2015.

Dr. Sosa is an endocrine surgeon who trained at Johns Hopkins University and the University of Oxford, and came to UCSF from Duke, where she was Chief of Endocrine Surgery and Leader of the Endocrine Neoplasia Diseases Group, as well as Director of the Surgical Center for Outcomes Research. Dr. Farmer is a pediatric surgeon who was Chief of Pediatric Surgery at UCSF before beginning her tenure as Chair at UCD. Dr. Hawn is a minimally invasive foregut surgeon who trained at the University of Michigan and came to Stanford after nearly 14 years at the University of Alabama, Birmingham.

To gain insight into their successes and challenges, we asked each of these remarkable women two questions:

1) What was the most significant challenge you faced on your path to becoming a chair of surgery and how did you overcome this?

DF:

“The hardest part of becoming a chair at UC Davis was leaving UCSF which had been my surgical home for so long. The good news has been that I am still able to serve the UC system and have maintained many friendships and collaborations with colleagues at UCSF. UC Health is at its strongest when working together.”

MH:

“My husband is an otolaryngologist and we began our academic careers at the same time.  As we both became more successful and advanced in our fields, we each had individual opportunities to consider, but it was a challenge to find opportunities for both of us. We were also incredibly happy in our positions and our community. When the opportunities came along at Stanford, it was not an easy choice. It took a lot of negotiations, not only between us, but also our 14- and 16-year-old kids. We leaned on many friends, colleagues and mentors to help us think through our decisions and give us guidance on the transition. Having a network of friends and mentors is incredibly important as leadership can be lonely.”

JAS:

“We all know the adage “don’t judge a book by its cover”, yet we still do so, often. I am a woman, 5’5″ tall, thin, and younger appearing than stated age. My youthful look has been an impediment, frequently being misjudged up front as a proxy for potential inexperience. I have had interviewers look incredulously at my C.V. and then back at me, as if they were trying to reconcile their own unconscious bias with the evidence presented before them. I do realize that (particularly) women in our society are very much judged by their appearance, and so much emphasis is placed on making sure we “look the part”, “fit in”, and conform to societal norms. As a chair, I am now much more aware of my own biases, actively trying to avoid making assumptions about people based on cues such as looks, dress, mannerisms, accents. etc. We all have implicit biases, but making concerted efforts to bring these to the forefront and recognize them intentionally, is the first step towards conquering them.”

2) Since becoming a chair of surgery, what one or two tasks are you most proud of accomplishing?

DF:

“Being chair of the department of surgery is one of the most fabulous jobs I can imagine. For me, it was an opportunity to take an educationally exceptional department and transform it into a multidisciplinary specialty, high-tech, complex surgical department. It’s been fun to bring a new level of skill to the Sacramento region. One of the great advantages of having a health system at UC Davis is leveraging the resources of the Davis campus. The veterinary school, the school of engineering and bioengineering, the public policy institute, all the many areas of expertise leveraging them in the service of human health. We have opportunities here at UC Davis Health that are unparalleled and have impact for vast reaches of inland California.”

MH:

“A.  Creating a health services research center to nurture and support the research of our faculty and trainees and

B.  Enhancing the culture of inclusion by creating several vice-chair leadership roles for the department to carry forward our important missions of research, education and clinical care as well as prioritizing diversity, inclusion and wellness”

JAS:

“My proudest accomplishments over the last year and a half (Has it been that long? Time flies when you are having fun!) have been building an organismal rather than hierarchical structure in the department. We are empowering and developing faculty into leaders in an open way, establishing inaugural vice-chairs and new surgical divisions, assigning terms and stewardship reviews, providing coaching for our new faculty leaders and ongoing skill-building opportunities for all. We are creating a culture of transparency and equity around salaries, promotions, career opportunities, and issues of diversity, equity, and inclusion.”

Particularly over the past 20 years, women have continued to gain power and momentum in surgical fields, which is exemplified by this incredible culture of leadership in the Bay Area. As we come together at the end of the month to share our scientific discoveries and connect with colleagues from across the country through the ACS and AWS meetings, we hope these stories will serve as a reminder that, as women in surgery today, we are truly standing on the shoulders of giants. 

Hillary J. Braun MD is a fourth year general surgery resident at the University of California, San Francisco (UCSF) who is currently a research resident in the Division of Transplantation. She is a graduate of Stanford University and UCSF Medical School. Dr. Braun plans to pursue an abdominal transplant fellowship following completion of her training in general surgery. She is interested in living donor liver transplantation, liver allocation policy, and liver regeneration. Dr. Braun is also a member of the UCSF Muriel Steele Society Council, serving on both the Programming and Medical Student Committees. 

Marissa A. Boeck MD, MPH is a Clinical Instructor and second-year trauma fellow at Zuckerberg San Francisco General Hospital/University of California San Francisco (UCSF). She is a graduate of the City University of New York Macaulay Honors College at Hunter College and Weill Cornell Medical College. Marissa completed her general surgical residency training at NewYork-Presbyterian Hospital/Columbia. She is passionate about diversity in the surgical workforce, the power of social media in medicine, and global public health, especially as it relates to injury prevention, emergency response, and trauma and surgical system strengthening in low-resource settings. She is also a member of the inaugural UCSF Muriel Steele Society Council, serving on both the Communications and Programming Committees, whose mission is to inspire, support, and promote women surgeons so they can thrive at all stages of their careers. You can find her on Twitter at @KickAsana. 

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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.