Tuesday, August 11, 2015

What does #ILookLikeASurgeon really say about surgeons around the world? A Call to Action

Ed Fitzgerald

Sitting in London on Friday afternoon, I was intrigued to see the first #ILookLikeASurgeon tweet from Heather Logghe, a call-to-arms which rapidly opened up a floodgate of international support.

Diversity and equality in surgery has long been a thorny issue on both sides of the Atlantic and beyond. In England, I previously wrote a paper reporting that over half of male and two-thirds of female newly graduated doctors did not think surgery welcomed women, so I was interested to see what the response would be to this Twitter campaign. I don’t think anyone could have imagined the strength of support in the 48 hours that followed.

To put this in an English context, recent figures indicate that only 11% of the consultant (attending) surgical workforce is female, ranging from 21.5% of pediatric surgeons to 4% of cardiothoracic surgeons. As recently as 2000, women made up just 5.9% of the surgical workforce, so while the situation has improved, surgery has a problem. Dig a little deeper into these figures and generational differences start to shed greater light on the current debate, with 30% of surgical trainees now female. Their voice was clear and loud enough to be heard this weekend: society is moving on, and surgery risks being left behind.

Such deep-seated cultural issues are little surprise here when the wider role of women in medicine faces outmoded opinions from within, guaranteed to provoke a visceral response from any reasonable reader.

So what have we learnt from the overwhelming success of this weekend’s hashtag trend? On a personal, professional and societal level, I’d suggest we’ve learnt a great deal.

Heather’s original blog began with the tagline ‘Be the role model you always wanted but never had’. On a personal level, the community rising through Twitter this weekend demonstrated the breadth of outstanding role models that already exist among us, but that many never knew. When social media can unite this globally, we are all stronger. It was humbling to see the pride in these pictures, and I hope that those tweeting in support realize that they themselves become the role models that will inspire others with their achievements to-date.

Yet on a professional level, this was always about far more than simply shattering stereotypes and finding role models. The frustration of many women in surgery found a long-overdue vent this weekend. From pre-filled operation reports always wrongly titled ‘Mr’, to repeatedly being told ‘you don’t look like a surgeon’ or ‘you'll never get it’, this celebration of diversity carried a cathartic edge. The rapidly accelerating momentum was testament to this. Everyone encounters stereotypes, but would this have gained the same traction if equality of opportunity and acceptance of diversity wasn’t at the heart of this?

At a societal level, what did onlookers see? #ILookLikeASurgeon received over 15 million impressions on Twitter and over 6,000 tweets, numbers which are surely set to rise. They saw surgeons in scrubs, but many more will have seen female surgeons as family members and mothers. As a society, we were reminded that whatever challenges it takes a man to reach the pinnacle of his profession, at best a woman in the same place will have balanced family, childcare and more. At worst, she will have felt it necessary to sacrifice these for career advancement. Is this really societal progress? Do we accommodate this, or even openly recognize this in surgery yet? Again, if the answer was yes, would this have hashtag have gained such traction?

At the start of this weekend we were all challenged to tweet #ILookLikeASurgeon and own it. Across the globe, thousands did. From Mexico to Saudi Arabia, Australia to Colombia, Pakistan to Spain, international support and selfies flowed in.

At the end of the weekend it’s now vital we ask other groups to ‘own it’. We can’t change the world with a hashtag, but this is where it starts. Smashing stereotypes, promoting diversity, and challenging cultures needs support from those that have the power to influence entire professions. How will the American College of Surgeons now step-up to address these issues? What leadership will the Royal College of Surgeons of England, with its first ever female president in 214-years, now provide?

For the sake of all those who stood up this weekend and said #ILookLikeASurgeon, it’s time to listen. Around the world, they told us that opportunity and equality is not yet achieved. For the sake of our patients, our profession, and our wider society, it’s time to give these issues the attention they deserve and tackle them head-on. How will you help?


And Heather says, keep tweeting! This movement is for all of us. We all need to own it and #CelebrateDiversity. Take the lead from Dr. Brendon Stiles and post your pic in solidarity of diverse surgeons around the world!





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