What would you recommend to those junior sur-
geons (students, trainees, faculty) who are looking
to champion diversity at their institutions?
Understand that no matter where you are, wherever you sit, wherever you were born, whatever
your experiences, we all need to pay attention to
inclusion and diversity. As you sit at a table or you
sit with your team, you want to see a mosaic—you
want to see different people with whom you interact each day.
At Johns Hopkins, we did an exercise during our
diversity training. There was a box of beads of different colors: white, brown, black, and yellow. The
instructors said, “Take the beads out according to
the color of the people you spend time with during
the day.” We realized very quickly that probably 80
to 90 percent of those with whom we interact look
like us. As you look at your immediate team, if a
mosaic is what you want to look like, then you need
to really stretch to make that happen.
Part of it is just being aware that people who
look like you may think differently than you, too.
There are generational differences. When you look
at women surgeons, you see women in their 30s,
40s, and 50s practicing. In a practice, there may be
surgeons who are of different generations.
How have you been affected by bias, and do you
have any tips on how to manage it?
I was interviewing for surgery residency in 1979 in
Los Angeles. The chairman welcomed all young men
and said, “Oh, and one woman.” I was only the sixth
woman to finish at UCLA. I was only the sixth woman
to get her vascular certification. At my first two jobs,
I was the only woman on the surgical faculty at the
University of California-San Diego and UCLA. When
I went to Milwaukee, WI, I was one of two women
I think for me the part that was so hard was being
the only woman. People really were watching you
closely. I really felt that you had to perform in a very
good way, not only to survive and make it, but also
to allow someone else to come behind you. If you did
not do a good job, they might not allow other women
into the program. I was really worried about that. I
don’t remember feeling that I experienced unconscious bias or issues. I did know when I interviewed
at UCLA for residency they were graduating a woman
chief resident that year. I realized that she survived,
so I probably could survive.
I think there were issues when I was looking for
chair of surgery jobs. I had a dean at a very prominent medical school tell me over the phone that I was
terribly qualified, but he didn’t think that he could
hire his first woman chair ever in the department of
surgery. He didn’t think culturally that his team was
ready for it. In 2002, I was offered a job as chair at
another institution, and then the offer was rescinded
two weeks later because they didn’t think that they
could support a woman. They really felt it was gen-der-oriented and not based on qualifications. I ended
up getting the job at Hopkins, where I did have a
supportive dean. But I was the only woman clinical
chair. It was very groundbreaking. Now, there are 22
women surgery chairs across the country.
I think we have to challenge leaders to have the
backs of the diverse people they hire. If they can’t do
it, then it would not be worth it. They have to have
your back to make you successful.
In the Journal of the American College of Surgeons, I
wrote about how I wanted to go to the University of
California San Francisco. Twenty years later, a Fellow
of the American College of Surgeons told me that
there were three women resident applicants the year
I applied. The chair decided not to rank any women
that year. Sometimes people will do things, and they
don’t even realize it. That’s why implicit bias training is
important. It’s probably not overt bias but unconscious
bias. We have implicit bias training for all our search
committees and all our medical students.