Recently, Indiana University School of Medicine Department of Surgery has conducted three faculty focus groups exploring issues around inclusiveness in the department.
The discussion began with a review of current U.S. data that shows that women constitute 48 percent of medical students and 24 percent of surgery residents. In academic surgery, women make up 25 percent of the assistant professors, 17 percent of associate professors, 9 percent of professors and 5 percent of chairs. Among academic surgeons, 10.8 percent are Asian-Americans, 2.9 percent are African-Americans and 3.6 percent are Latino. The group explored a number of key questions such as:
- What could we do to assure that all voices are heard in the Department of Surgery?
- Are there policies, procedures or micro-aggressions that suggest discrimination against women or men and women of color in surgery and if so, how can we change this?
- What specific ideas can we generate for increasing the number of women in leadership roles in surgery?
- Is there any evidence of implicit or unconscious bias in surgery and if so, should we embark on bias training for all faculty?
- How do we deal with the leadership challenge of preserving the culture by occasionally requiring some faculty to leave the department, while preserving the dignity of those asked to leave? How could we do this better?
A number of recommendations have come from these focus groups including the following:
- With significant discrimination particularly against women residents and even junior faculty in the operating room, sessions should be incorporated into the Skills Laboratory curriculum that engages operating room circulators and scrub-nurses.
- All leadership must be culturally intelligent as diversity increases innovation only in groups with culturally intelligent leadership.
- As a way of assessing progress in recruitment of women and minorities, an excellent recruitment question to candidates would be “What have you heard about IU School of Medicine Department of Surgery in this regard?”
- Increasing diversity in surgery will require more than policy and recruitment announcements and will require aggressive direct recruitment of individuals that will make us a more diverse group.
- In an effort to advance cognitive diversity, leadership must value departmental contributions beyond Relative Value Units and National Institutes of Health grants, as this clearly places some at a disadvantage.
Perhaps the most important recommendation made during these focus groups was that the department needs to make a concerted effort to continue this discussion in meaningful ways. Faculty and residents are encouraged to suggest ways that we can keep this conversation going.