Intentionality Is Needed to Diversify Surgical Leadership

Abstract

Diversification of the surgical workforce such that it is reflective of the patient population we serve remains crucial to optimizing patient care outcomes and achieving equitable provision of high-quality health care. In this issue of JAMA Surgery, Iwai et al 1 explore the dynamics of race, gender, and intersectionality across various leadership roles in surgery. They found an unsettlingly low rate of representation of women and racial and ethnic underrepresented in medicine (URiM) groups in leadership positions at all levels, even lower than would be expected when accounting for the underrepresentation of surgeons from these subgroups. However, what was more concerning is that increased diversification was observed in roles that may not lead to advancement to higher leadership positions, such as chairs. For example, more women and women of URiM faculty held vice chair positions as compared with division chief roles and more diversification was noted with the vice chair of diversity, equity, and inclusion, and vice chair of faculty development roles.These findings have important implications for diversification efforts in surgical departments. Although well meaning, diversification efforts that are limited to leadership positions viewed primarily as service roles may ultimately have a superficial, rather than substantive, impact on diversification at the departmental level. If diverse individuals within a surgical department are only given leadership opportunities that do not ultimately result in leadership advancement to the role of chair, diversification at an organizational level will not occur and those within an organization will come to view these specific roles as peripheral to a department's mission or less important for their career advancement. This, in turn, sets those underrepresented surgeons holding such leadership roles up for failure, further exacerbating the gaps in representation at the uppermost levels.

Leadership roles in US surgery lack diversity, study finds

“…In an accompanying editorial Melina Kibbe, dean of the University of Virginia School of Medicine, said that diversifying the surgical workforce was crucial to improving patient outcomes 2…”