Skip to main content

Advertisement

SpringerLink
Log in

Diversity in Surgery: A Historical, International, and Contemporary Perspective

  • Diversity in the Surgical Profession (S Pitt, Section Editor)
  • Published:
Current Surgery Reports Aims and scope Submit manuscript

A Correction to this article was published on 17 June 2021

This article has been updated

Abstract

Purpose of Review

The major challenges to entry and advancement in surgical careers encountered by women and by underrepresented minority (URM) groups are sadly centuries old problems. Despite relatively recent recognition of significant disparities in equity and equality and under-representation in surgery, these unacceptable problems persist. The traditional lack of diversity seems to have persisted longer and in a more apparent way in surgery than in other disciplines within medicine and as compared to other professions. It is well recognized that diversity is a major workplace asset as attested to by a myriad of objective metrics.

Recent Findings

Some of the disturbing inequities experienced by women and by other URM groups include income, career promotion, and academic recognition, despite adjusting for age, specialty, productivity, and years of experience. While some improvements have been made, much work remains to be done to address and rectify these inappropriate and unacceptable disparities. Success is contingent upon delivery of this crucial message. The traditional channels of dissemination of such information including the publication of peer-reviewed manuscripts, the delivery of lectures, and the establishment of organizations have been augmented by the use of social media platforms.

Summary

Social media has emerged as a democratizer, giving voice to all surgeons regardless of gender identification, race, nationality, ethnicity, religious beliefs, sexual preferences, or other demographic factors. Furthermore, the immediacy of social media allows surgeons all over the world to connect and share these issues regardless of location or time zone. Success in increasing diversity will benefit surgeons, surgeons’ workplaces, and patients, representing a rational and wise use of social media to catalyze and expedite this success.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Change history

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Solecki RS, Solecki RL, Agelarakis AP. The proto-neolithic cemetery in Shanidar Cave. College Station: Texas A&M University Press; 2004.

    Google Scholar 

  2. •Pastena JA. Women in surgery: an ancient tradition. Arch Surg. 1993;128(6):622–6. This publication compiles the trajectory of women in surgery

  3. Burdett HC. Hospitals and asylums of the world. London: J & A Churchill; 1891.

    Google Scholar 

  4. Mercuriale G. De arte gymnastica: frisius. Florence: Olschki; 2008.

    Google Scholar 

  5. Olivieri JWA. AetiiAmideniLibriMedicinales I-IV. Pp. xvii+ 408. (Corpus MedicorumGraecorum VIII I.) Leipzig and Berlin: Teubner, 1935. Export prices: paper, RM. 20.25; bound, 21.75. Class Rev. 1937;51(4):148.

    Google Scholar 

  6. Miller-Rosser K, Chapman Y, Francis K. Historical, cultural, and contemporary influences on the status of women in nursing in Saudi Arabia. Online J Issues Nurs. 2006;11(3):8.

    PubMed  Google Scholar 

  7. Mead KCH. A history of women in medicine: from the earliest times to the beginning of the nineteenth century. Haddam: Haddam Press; 1938.

    Google Scholar 

  8. Majumdar SK. History of women in surgery: an overview. Bull Indian InstHist Med Hyderabad. 2000;30(1):59–64.

    CAS  Google Scholar 

  9. Hacker C. The indomitable lady doctors (Toronto: Clarke Irwin, 1974), 40–50. For additional background, see Lawrence Longo, “electrotherapy in gynecology: the American experience.” Bull Hist Med. 1986;60:343–66.

    Google Scholar 

  10. Sabin F, Macken JE. Elizabeth Blackwell, the First Woman Doctor. Mahwah: Troll Associates; 1982.

    Google Scholar 

  11. Walker DL. Mary Edwards walker: above and beyond. New York: Forge Books; 2005.

    Google Scholar 

  12. Todd MG, Travers G. The life of Sophia Jex-Blake. London: Macmillan; 1918.

    Google Scholar 

  13. Ellis H. Eleanor Davies-Colley: the first woman FRCS. J PerioperPract. 2009;19(3):118–9.

    Google Scholar 

  14. Morgan TM. The education and medical practice of Dr. James McCune Smith (1813–1865), first black American to hold a medical degree. J Natl Med Assoc. 2003;95(7):603.

    PubMed  PubMed Central  Google Scholar 

  15. Weisse AB. Cardiac surgery: a century of progress. Tex Heart Inst J. 2011;38(5):486.

    PubMed  PubMed Central  Google Scholar 

  16. NLM/NHI. Biography Dr. M. Joycelyn Elders. https://cfmedicine.nlm.nih.gov/physicians/biography_98.html. Accessed 29 Mar 2021

  17. NLM/NIH. Biography Dr. Antonia Novello. https://cfmedicine.nlm.nih.gov/physicians/biography_239.html

  18. England RCoSo. Women in Surgery. Statistics. https://www.rcseng.ac.uk/careers-in-surgery/women-in-surgery/statistics/ (2020). Accessed 29 Mar 2021

  19. Digital N. Narrowing of NHS gender divide but men still the majority in senior roles. (2018).https://digital.nhs.uk/news-and-events/news/narrowing-of-nhs-gender-divide-but-men-still-the-majority-in-senior-roles . Accessed 29 Mar 2021

  20. Surgeons BotACo. 2018 ACS Governors Survey: gender inequality and harassment remain a challenge in surgery. (2018).https://bulletin.facs.org/2019/09/2018-acs-governors-survey-gender-inequality-and-harassment-remain-a-challenge-in-surgery/#:~:text=In%202017%2C%20for%20the%20first,of%20general%20surgeons%20were%20women. Accessed 29 Mar 2021

  21. Hardouin S, Cheng TW, Mitchell EL, Raulli SJ, Jones DW, Siracuse JJ, Farber A. RETRACTED: prevalence of unprofessional social media content among young vascular surgeons. J Vasc Surg. 2020;72(2):667-71

  22. Sosa JA. Doubling down on diversity in the wake of the# MedBikini Controversy. World J Surg. 2020;44(11):3587–8.

    Article  Google Scholar 

  23. •Kibbe MR, Freischlag J. Call to action to all surgery journal editors for diversity in the editorial and peer review process. JAMA Surg. 2020. https://doi.org/10.1001/jamasurg.2020.4549. This publication analyces the situation of editorial boards of surgical journal and alerts about the consequences of lack of diversity

  24. •Behrns KE, Wexner SD. The importance of social media to Surgery. Surgery. 2020;168(5):769. This publication highlights how social media have given voice to surgeons around the world and their impact in disseminating surgical knowledge

  25. Cirujanos AEd. Memoria Annual. (2018).https://www.aecirujanos.es/memoria2019/. Accessed 29 Mar 2021

  26. Explorer S. Surgery average salaries in Germany 2020. (2020). http://www.salaryexplorer.com/salary-survey.php?loc=81&loctype=1&job=18&jobtype=2Accessed 29 Mar 2021

  27. Sagar S. Women in Surgery: A perspective from India www.womensurgeons.org2016https://www.womensurgeons.org/news/news.asp?id=386437.

  28. Hamdan A. Women and education in Saudi Arabia: challenges and achievements. Int Electron J. 2005;6(1):42–64.

    Google Scholar 

  29. Ministry of Health KoSA. Graduates in University Colleges of Medicine and Health 2015/2016 Statistical Year Book 2015. Riyadh: Ministry of Health KoSA; 2015. p. 123.

    Google Scholar 

  30. Al-Rashed AM, Al Youha SA, Al Safi SH. The history and current status of women in surgery in the Arabian Gulf. IJS Global Health. 2020;3(5):e23.

    Google Scholar 

  31. Jena AB, Olenski AR, Blumenthal DM. Sex differences in physician salary in US public medical schools. JAMA Int Med. 2016;176(9):1294–304.

    Article  Google Scholar 

  32. Surgeons W. Gender Equity Toolkit. 2020. https://www.iapb.org/learn/knowledge-hub/gender-equity-toolkit/

  33. Surgeons AoW. Association of women surgeons statement on gender salary equity. (2017). https://cdn.ymaws.com/womensurgeons.site-ym.com/resource/resmgr/docs/Gender_Equity_Resources/2017-AWS-Gender-Salary-Equit.pdf (2017). Accessed 29 Mar 2021

  34. Surgeons ACo. Statement on Gender Salary Equity. (2017).https://www.facs.org/about-acs/statements/101-gender-salary-equity. Accessed 29 Mar 2021

  35. Sanfey H, Crandall M, Shaughnessy E, Stein SL, Cochran A, Parangi S, et al. Strategies for identifying and closing the gender salary gap in surgery. J Am Coll Surg. 2017;225(2):333–8.

    Article  Google Scholar 

  36. Wilcox AR, Trooboff SW, Lai CS, Turner PL, Wong SL. Trends in gender representation at the American College of surgeons clinical congress and the academic surgical congress: a mixed picture of progress. J Am Coll Surg. 2019;229(4):397–403.

    Article  Google Scholar 

  37. Atkinson R, Lu P, Cho NL, Melnitchouk N, Kuo LE. Gender disparities in award recipients from surgical specialty societies. Surgery. 2019;166(3):423–8.

    Article  Google Scholar 

  38. •Gardner AK, Harris TB. Beyond numbers: achieving equity, inclusion, and excellence. Ann Surg. 2020;271(3):425–6. This publication highlits the importance of diversity to enrich surgical taskforces

  39. Rangel EL, Smink DS, Castillo-Angeles M, Kwakye G, Changala M, Haider AH, et al. Pregnancy and motherhood during surgical training. JAMA Surg. 2018;153(7):644–52.

    Article  Google Scholar 

  40. Surgeons TACo. Statement on the importance of pregnancy, parental leave, and workplace accommodations for surgical residents and fellows. https://www.facs.org/about-acs/statements/121-parental-leave (2020)

  41. Abelson JS, Symer MM, Yeo HL, Butler PD, Dolan PT, Moo TA, et al. Surgical time out: our counts are still short on racial diversity in academic surgery. Am J Surg. 2018;215(4):542–8.

    Article  Google Scholar 

  42. McKinley SK, Parangi S. Addressing sexual harassment in surgical training. Ann Surg. 2020;271(4):614–5.

    Article  Google Scholar 

  43. Hu Y-Y, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. New Engl J Med. 2019;381(18):1741–52.

    Article  Google Scholar 

  44. The American College of Surgeons (ACS) Women in Surgery Committee icwtCoD. Statement on harassment, bullying, and discrimination 2019. (2019)https://bulletin.facs.org/2019/09/statement-on-harassment-bullying-and-discrimination/. Accessed 29 Mar 2021

  45. Nukala M, Freedman-Weiss M, Yoo P, Smeds MR. Sexual harassment in vascular surgery training programs. Ann Vasc Surg. 2020;62:92–7.

    Article  Google Scholar 

  46. Surgeons TAoW. History. https://www.womensurgeons.org/page/History

  47. Surgeons TACo. Women in Surgery Committee. https://www.facs.org/about-acs/governance/acs-committees/women-in-surgery-committee (2020)

  48. Royal Australasian College of Surgeons. Women in surgery section business plan 2017–2021. Melbourne: Royal Australasian College of Surgeons; 2017.

    Google Scholar 

  49. https://www.rcsi.com/careers/why-rcsi/equality-diversity-and-inclusion. Accessed 31 Oct 2020

  50. •Wexner S, Petrucci A, Brady R, Ennis‐O'Connor M, Fitzgerald J, Mayol J. Social media in colorectal surgery. Colorectal Dis. 2017;19(2):105–14. This publication reveals how powerful are social media to develop global networks

  51. •Mayol J, Dziakova J. Value of social media in advancing surgical research. Br J Surg. 2017;104(13):1753–55. This publication focuses on the value of the immediacy of social media

  52. DiLosa K, Drudi LM, Hata K, Devrome AN, Yang Y, Shraga S, et al. Changing tides: a vascular surgery trainee perspective on the# MedBikini Campaign and a call for action. J Vasc Surg. 2020;72(5):1819–20.

    Article  Google Scholar 

  53. •Ellis DI, Khubchandani JA. The State of Diversity in American Surgery: a call to action. Ann Surg. 2020. https://doi.org/10.1097/SLA.0000000000004518. This publication summarizes the situation of diversity in Surgery in the USA and encourages hospitals, departments and administration to implement programs on diversity.

  54. Education AC for GM. (2019)

  55. Jarman BT, Kallies KJ, Joshi AR, Smink DS, Sarosi GA, Chang L, et al. Underrepresented minorities are underrepresented among general surgery applicants selected to interview. J Surg Educ. 2019;76(6):e15–23.

    Article  Google Scholar 

  56. Osseo-Asare A, Balasuriya L, Huot SJ, Keene D, Berg D, Nunez-Smith M et al. Minority resident physicians’ views on the role of race/ethnicity in their training experiences in the workplace. JAMA Netw Open 2018;1(5):e182723

  57. •Johnson SK. Inclusify: the power of uniqueness and belonging to build innovative teams. New York: Harper Collins; 2020. This book details how important is diversity when building teams

  58. Keller DS, Berho M, Brown G, Hull T, Moeslein G, Wexner SD. A narrative celebrating the recent contributions of women to colorectal surgery. Surgery 2020;168(3)355-362

    Article  Google Scholar 

  59. https://aischannel.com/

  60. https://www.sbas.net/

  61. https://www.asiansurgeon.org/

  62. https://www.facs.org/advocacy/participate/summit

Download references

Author information

Authors and Affiliations

  1. King Khalid University Hospital, Alkhalidiyyah, Najran, 66262, NJ, Saudi Arabia

    Delia Cortés-Guiral

  2. Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense, Madrid, Spain

    Julio Mayol

  3. Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner

Authors
  1. Delia Cortés-Guiral
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julio Mayol
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steven D. Wexner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Delia Cortés-Guiral.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical collection on Diversity in the Surgical Profession.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cortés-Guiral, D., Mayol, J. & Wexner, S.D. Diversity in Surgery: A Historical, International, and Contemporary Perspective. Curr Surg Rep 9, 14 (2021). https://doi.org/10.1007/s40137-021-00289-3

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40137-021-00289-3

Keywords

Search

Navigation