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Calling attention to the disparity in surgery: Here’s what I learned

Andrea L. Merrill, MD
Physician
July 3, 2015
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On Monday, June 1st, I awoke with a mixture of butterflies and excitement. Every 30 minutes I checked online to see if it was up. My heart pounded every time I clicked the refresh button. Finally, around noon, there it was — my first piece of medical writing, published on KevinMD.com.

In medicine, we often present objective facts. We give a succinct history, recite vital signs, and record exact lab values before putting all the hard evidence together to formulate our, hopefully evidence-based assessment and plan. While there is often an “art” to medicine and physicians do disagree at times, there is little opportunity to express our personal opinions, views, and feelings.

This article was different. Here I was, exposing myself to the public and even more intimidating my colleagues. Entitled, “Why are women so underrepresented in surgery leadership?” it was meant to spark discussion and even controversy. Yet, I feared criticism from both my male and female colleagues. Would my female colleagues agree with my experience? Would they appreciate me highlighting the bias we face or do they just want to continue doing their jobs without raising a “fuss”? And my male colleagues, would they accuse me of complaining or playing the victim?

As I write this, there have been two timely events highlighting the ongoing sexism in the workplace, specifically in the area of science.

  1. In an advice column in Science Magazine, Caltech faculty member, Alice Huang, gave misguided advice to a young female researcher asking how to deal with a male advisor who could only focus on her chest during meetings. Huang counseled, “I suggest you put up with it … Just make sure that he is listening to you … His attention on your chest may be unwelcome, but you need his attention on your science and his best advice.” Internet backlash ensued, prompting the hashtags #worsesciencecareeradvice and #dontaskalice, and eventually, Science Magazine retracted the column.
  2. British biochemist and Nobel Prize winner Tim Hunt advocated for single-sex science labs this week, saying, “Three things happen when [women] are in the lab: You fall in love with them, they fall in love with you, and when you criticize them, they cry.” Again, the world took to the Internet to retaliate to this ignorant comment.

While these two incidents highlight that sexism in the workplace is ongoing and spans many professions, there may be hope yet. After my article was posted, so many friends, colleagues, and Twitter followers, both male and female, reached out to me to either share their similar experiences or to offer positive and supportive feedback. Here is just a small sample:

“Great article! Most of the women I know in surgery are awesome and beat the guys, hands down! And you are so right. Women can be feminine and amazing surgeons without being pigeon-holed.”

“It actually echoes a lot of the issues my female students at Stanford Business School raise in my classes. Strong women leaders still face a unique double standard of needing to be seen as competent and warm.”

“I had a similar experience; as a medical student, I was told by a male attending that women are seen as only one of two things. He told us, ‘Decide who you want to be, a bitch or a pushover.'”

“My institution is doing research investigating strategies to empower female residents to help them identify and attain desired leadership positions. Sorely needed. From a purely statistical standpoint, it seems unlikely that the discrepancy is due solely to choice. I think being mistaken for nurses (the same thing happens to male nurses, of course) will dissipate over time. Great post!”

“Proud of you for addressing this inconsistency in medicine and surgery! It may take another generation for this bias to be addressed better.”

“Great article — it is a call for all within academic surgery departments to do more to create a supportive environment without the overt and subtle gender-biased cues.”

“When it came time to find my first job, I asked my female colleagues how they had negotiated their contract. None of them had negotiated their contracts, as they never received that advice. When I asked my male colleagues, all of them had been advised on negotiating their contracts.”

“Awesome article (passing it along to my students who are pre-med). The issues you address are obviously specific to your field, but thematically they’re universal to women in high-powered professions. Keep breaking barriers and mentoring younger surgeons; they need you!”

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“I loved that the wife of a patient today told me how excited she was to share with her friends that ‘there’s a whole team of doctors, but a chick is in charge!”

“My orthopedic surgeon is a woman who is of a ‘certain age.’ I give her so much credit for going into a field she loves.”

By the end of the day, my butterflies had faded, replaced with euphoria and gratitude for the widespread support. The world is taking note of the sexism that exists in the workplace and people are speaking up. Obviously, we still have many hurdles to overcome to achieve equality in surgery, and in many other professions. But getting our voices out there and calling attention to the disparity is a start. And as my voice has shown, people will listen!

Andrea L. Merrill is an assistant professor of surgery at the Chobanian and Avedisian School of Medicine and a surgical oncologist at Boston Medical Center. She can be reached at Scrubbed Out, on Instagram @anjlm and @scrubbedoutsurgeon and X @AndreaLMerrill. She possesses advanced training in breast cancer and endocrine diseases. Dr. Merrill earned her undergraduate and medical degrees at Tufts University. She completed her residency training in general surgery at Massachusetts General Hospital, an editorial fellowship at the New England Journal of Medicine, and a surgery fellowship in complex surgical oncology at The Ohio State University.

Image credit: Shutterstock.com

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Calling attention to the disparity in surgery: Here’s what I learned
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