Diversity & Inclusion in Surgery

By Shree Agrawal

Join in our upcoming Tweetchat in partnership with Association of Academic Surgery (AAS) on Monday, April 23, 8 pm ET. To participate, be sure to follow the moderators for this chat, Drs. Christian Jones (@jonessurgery) of AAS (@AcademicSurgery) and Michaela West (@MichaelaWst) of the Association of Women Surgeons (AWS). Please tag all of your tweets with the hashtag #AASAWSchat . 

Diversity

Diversity in medicine to me emphatically represents individuals with grit, who have overcome long-standing norms within their profession, and allies who have recognized and advocated for the inclusion of all individuals.  I am inspired when I meet trailblazers who bring the intersections of diversity up the ladder in surgery. Despite the advances many have made before us, diversity in medicine and especially surgery still have room to grow.

Medical education is beginning to become more diverse: women comprise 51% of medical school matriculants since 2017, and underrepresented minorities account for 11% of US medical graduates. Despite these positive changes, approximately 30% of students who identify as a non-binary gender or a sexual orientation minority, do not reveal their identity for fear of discrimination.  Furthermore, data has not been collected to represent minority populations as defined by gender and sexual orientation within medical education.

However, there is  a stark contrast in the practice of surgery from post-graduate training to patterns in the workforce:

• • Across all medical specialties,  29% of all full-time faculty are women, of which 4% also identify as an underrepresented minority

• • Among full professors of surgery, less than 10% are women and only 22 of surgical department chairs in the United States and Canada are women.

• • As of 2008, underrepresented minorities made up 7% of surgical faculty members and 5% are considered surgical full professors.

• Of all surgical trainees, 10% identify as an underrepresented minority.

AAMC 2016 Physician Specialty Data Report

Inclusion

“Belonging is being somewhere where you want to be, and they want you.  Fitting in is being somewhere where you want to be but they don’t care one way or the other.” – Brene Brown

In the business sector, companies who intentionally created a more diverse workforce were more innovative, able to see potential obstacles more easily and created an additional 15-35% financial return.  In the landscape of healthcare disparities with a diverse patient population, it would seem essential to have diversity among healthcare providers addressing patient needs. The visibility of diversity within our healthcare institutions provides a natural forward momentum to create inclusion at leadership and faculty levels.  To demonstrate the value of individuals from diverse backgrounds to continue to enter fields in which they are underrepresented, visibility and inclusion demonstrate progress.

Inclusion also requires advocating and becoming allies for our peers to promote their own advancement.  Executing both roles can be challenging in academia and other practice settings. Below we provide a few tips for becoming an advocate and ally: 

• • Be a listener

• • Keep an open mind

• • As with our patients, respect and dignity are an undeniable right every human deserves, regardless of background.

• • Be mindful of your language—it matters.  Be intentional about your choice of pronouns, humor, and mannerisms.

• • Everyone has bias-confront your bias and prejudices.

• When you recognize discrimination, speak up to promote respect for your colleagues and patients and support your colleagues as they advocate for themselves.

Diversity includes, but is not limited to, race, socioeconomic background, gender, sexuality, and/or religion.  Within each aspect of diversity, individuals face varying degrees of discrimination, exclusion, and privilege, but it is at the intersections of these categories, that further challenges occur and can be compounded.  It is important to understand the unique, additional factors individuals may have had to overcome to be where they are today in medicine and look beyond the data we typically focus on such as race and binary gender.

The future of surgery relies on our ability to reflect the population of patients we serve – to be both diverse and inclusive. How can we best support each other and be allies to those around us?

We hope to hear your thoughts next Monday to talk more about diversity within surgery and how to become an ally and advocate for inclusion. #AASAWSChat with @WomenSurgeons and @AcademicSurgery

Shree is a fourth year medical student at Case Western Reserve University, where she also completed her bachelors of science degree in biology. Currently, she is completing a clinical research fellowship in genitourinary reconstruction at the Glickman Urological and Kidney Institute at Cleveland Clinic and serving as the Chair of the AWS National Medical Student Committee. Shree is passionate about research surrounding patient decision-making and medical education. In her free time, she enjoys blogging for AWS, practicing yoga, and boxing.

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.