Friday, August 21, 2015

#ILookLikeASurgeon 101: How to Be an Advocate for Surgical Workforce Diversity

Photo Credit

Marissa Boeck MD, MPH

Like many before and others who persist, I held out on speaking up about workforce gender inequalities. Despite repeated examples in my job as a female general surgery resident, I only paid vague attention to the equity campaigns that appeared in my Twitter feed, had minimal interactions with surgical society outreach programs for female surgical residents, and sporadically read news commentary on continued gender disparities in promotion and pay across industries. Through silence it would appear I was accepting circumstances as they were. I viewed Lean In, its rebuttal, and the #ThisIsWhatWeLookLike campaign from afar. It wasn’t that these issues didn’t resonate with me, but I simply didn’t have the time to participate. Surgical residency, make that a surgical career in general, remains incredibly demanding. This is despite 80-hour workweeks, still the equivalent of two full-time jobs in most fields, and an alleged recognition of the importance of work-life integration. Yet as a general surgery resident, adhering to a regular self-care regimen of sleep and food was challenging enough, without the added task of advocacy.

That is, until now. With research years affording a semblance of normalcy, combined with a Twitter-engaged female surgeon research mentor, I stumbled upon a movement at its inception. But it wasn’t only circumstance that pushed me to join; this somehow seemed different. A simple phrase, #ILookLikeASurgeon, captured a well acknowledged yet all-to-often marginalized inequality, culminating in a voice that was at last loud enough to be heard. Initially built on gender biases in surgery, the hashtag has evolved to represent the lofty aim of dispelling all stereotypes, arguing that physical traits do not equate with intellect, skill, or capability.

Borrowing a phrase from a well-known female surgeon role model Dr. Julie Freischlag, we now need “active transport” to disseminate and implement the #ILookLikeASurgeon principles, which will ideally become the new normal. As indirectly proven by the campaign’s popularity, the historic method of passive recognition is not enough, inadvertently propagating and perhaps even reinforcing the issues. Yet as others have pointed out, self-photographs of surgeons alone are also unlikely to lead to increased surgical leadership diversity, a more accepting work environment, or equality of pay. However, the five words of #ILookLikeASurgeon have hit a nerve, spawning an awe-inspiring global community of passionate individuals who together want to challenge the status quo, and truly alter the culture of surgery for the better.

Here are some ways to become a part of this extraordinary effort:

1. Join your Social Media (SoMe) platform of choice – or why not all of them? -  and post a picture!
Although born on Twitter, #ILookLikeASurgeon has expanded to include Facebook, Instagram, LinkedIn, and undoubtedly other platforms flying beneath the radar. Getting on SoMe is fairly simple:
1.     Sign up for an account (Twitter 101)
2.     Post a picture of yourself doing an activity of your choosing, showcasing that surgeons can and do look like anyone, making sure to use the #ILookLikeASurgeon hashtag. Other complimentary ones include: #ChallengeStereotypes, #DiversityMatters, #CelebrateDiversity, #BeTheChange, #HumanizeTheProfession…or make one yourself!
3.     Consider the judicious use of emoticons for further emphasis and effective use of limited space
4.     Like, retweet, and/or comment on posts from other community and organization members, showing camaraderie, engagement, and interest, which will hopefully encourage future posts
5.    For Twitter specifically, become savvy by following @Support and @TweetSmarter
6.     Start building a virtual community of engaged, passionate individuals, who you’ll likely cross paths with one day #IRL (in real life).
7.     Think about with whom the #ILookLikeASurgeon message will resonate most, and reach out! That’s the great thing about SoMe, former and current U.S. presidents to large organizations and celebrities are just a click, like, comment, or 140 characters away.

2. Encourage others to join the conversation – or as I like to refer to it: #PositivePeerPressure.
There are many within our surgical community who continue to resist the true power of SoMe. If breaking geographical and hierarchal barriers isn’t convincing enough, here are a couple of recent articles to persuade them to hop aboard the #SurgTweeting train:
1.     A recent blog post on KevinMD highlighting the need for SoMe in academic medicine
2.     Twitter 101

3. Share your perspective, experiences, and suggestions for change via a blog, editorial, op-ed, or letter to the editor.
Numerous inspiring, impassioned, genuine pieces have already been written, as many felt compelled to speak out as #ILookLikeASurgeon gained momentum. Yet there are undoubtedly more stories to be told, with words capable of powerfully capturing past and current struggles to inform the most needed future interventions. More importantly, these words have a truly global reach, serving as a missing message of encouragement or hope for those lacking local surgical mentors.

4. Website creation and development
Currently in the development phase, visit to sign up for site launch notifications. And if you are a tech guru, or even just a little tech savvy, we’d love your help!

5. Participate in events at the various meetings – or organize one yourself!
Planning for #ILookLikeASurgeon activities at the American College of Surgeons Clinical Congress 2015 is currently underway. Given the global response and interest, there’s no reason why #ILookLikeASurgeon events shouldn’t pop up around the world. Post on SoMe to gather local interest, reach out to societies and organizations in your country, and make the virtual tangible with real-life meet-ups. Not only does this create an environment for mentorship and solidarity, but also will generate discussions of local surgical workforce challenges and issues, laying the foundation for relevant, actionable targets for change.

6. Join the growing team behind #ILookLikeASurgeon, which welcomes your input and ideas for development and implementation of next steps
Everyone who posts on a SoMe platform is truly a part of #ILookLikeASurgeon. As the community grows from one to thousands, there is an emerging need for increased member involvement in order to transition from a virtual groundswell to concrete interventions. Please reach out if interested, including with ideas, partnerships or funding suggestions. Individuals from all levels of training are welcome!

“If we could change ourselves, the tendencies in the world would also change. As a man changes his own nature, so does the attitude of the world change towards him...We need not wait to see what others do.” –Mahatma Gandhi

Marissa Boeck MD, MPH @KickAsana

Post-Graduate Fellow in Global Health, 
Northwestern University Feinberg School of Medicine
Arthur Tracy Cabot Fellow, 
Harvard Center for Surgery and Public Health, 
Brigham and Women’s Hospital
General Surgery Resident, 
New York Presbyterian Hospital – Columbia


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