Reflections on women in surgery

Article Type
Changed
Fri, 01/18/2019 - 14:20

 

As I reflect upon the past year, 2018 has certainly made a mark for addressing burnout among medical professionals, enforcing wellness, and targeting implicit and explicit gender bias in medicine and surgery.

Dr. Laura Drudi
Dr. Laura Drudi

Looking back, I entered surgery with a dream to change the culture of surgery. I knew I didn’t fit the traditional mold of an aggressive or arrogant surgeon. But I thought that my empathetic, open, and compassionate ways may spark a change in paradigm for that traditional surgical ideology. However, what I encountered as I made my way on this long, ever-winding journey was a system, culture, and tradition that beats you down, and what I thought were my strengths were quickly turned into weaknesses. As I grew and matured, this loss of identity in a culture of depersonalization surrounded by gender bias, for me, was a perfect recipe leading straight to burnout. However, this was an impetus for change, to be that voice and spark for a cultural transformation of surgery and for the women who work in the specialty.

More women are entering medical and surgical specialties. However, despite the advances made there are still clear gender-based disparities influencing overall wellness and work satisfaction. For instance, a study by Meyerson et al. demonstrated that female residents receive less operating room autonomy than male ones. I see it daily within my own curriculum and in observing other female residents in other surgical specialties. Furthermore, female residents are less often introduced by their physician titles, compared with their male counterparts, are often confused as nonphysicians, and are perceived as being less competent. This influences, to no small extent, overall confidence. It’s discouraging and disheartening to have worked so hard and yet still be treated in a sexist paradigm. And to top it all off, female physicians face a motherhood penalty.

In a recent study by Magudia et al., out of 12 top medical institutions that provided maternity leave, only 8 did so for residents with a grant total of 6.6 weeks on average. Furthermore, women with children or women who plan to have children have constrained career opportunities and are less likely to get full professorship or leadership positions. Anecdotally, a surgeon in passing semijokingly told me that if I were to take a specific academic vascular position, I may have to sign an agreement not to get pregnant ... probably not the job for me.

It’s appalling that, in this day and age, these explicit beliefs still exist, but what scares me more are all the implicit unconscious biases that affect all women not only in surgery but in medicine as well.

Looking back, 2018 is a year of beginning difficult conversations about physician and surgeon wellness, burnout, and gender bias. What’s obvious is that there is a hell of a lot of work to do. But change is slowly starting. We are now recognizing what the issues are, and the next step is to take action. It’s difficult to steer big ships, but there is an active community investing in strategies to improve the cultural scope of surgery and supporting and valuing women and what they have to offer.

References

Magudia K et al. JAMA. 2018;320(22):2372-4.

Meyerson SL et al. J Surg Educ. 2017;74(6):e111-18.

Dr. Drudi is a vascular surgery resident at McGill University, Montreal, and the resident medical editor of Vascular Specialist.

Publications
Sections

 

As I reflect upon the past year, 2018 has certainly made a mark for addressing burnout among medical professionals, enforcing wellness, and targeting implicit and explicit gender bias in medicine and surgery.

Dr. Laura Drudi
Dr. Laura Drudi

Looking back, I entered surgery with a dream to change the culture of surgery. I knew I didn’t fit the traditional mold of an aggressive or arrogant surgeon. But I thought that my empathetic, open, and compassionate ways may spark a change in paradigm for that traditional surgical ideology. However, what I encountered as I made my way on this long, ever-winding journey was a system, culture, and tradition that beats you down, and what I thought were my strengths were quickly turned into weaknesses. As I grew and matured, this loss of identity in a culture of depersonalization surrounded by gender bias, for me, was a perfect recipe leading straight to burnout. However, this was an impetus for change, to be that voice and spark for a cultural transformation of surgery and for the women who work in the specialty.

More women are entering medical and surgical specialties. However, despite the advances made there are still clear gender-based disparities influencing overall wellness and work satisfaction. For instance, a study by Meyerson et al. demonstrated that female residents receive less operating room autonomy than male ones. I see it daily within my own curriculum and in observing other female residents in other surgical specialties. Furthermore, female residents are less often introduced by their physician titles, compared with their male counterparts, are often confused as nonphysicians, and are perceived as being less competent. This influences, to no small extent, overall confidence. It’s discouraging and disheartening to have worked so hard and yet still be treated in a sexist paradigm. And to top it all off, female physicians face a motherhood penalty.

In a recent study by Magudia et al., out of 12 top medical institutions that provided maternity leave, only 8 did so for residents with a grant total of 6.6 weeks on average. Furthermore, women with children or women who plan to have children have constrained career opportunities and are less likely to get full professorship or leadership positions. Anecdotally, a surgeon in passing semijokingly told me that if I were to take a specific academic vascular position, I may have to sign an agreement not to get pregnant ... probably not the job for me.

It’s appalling that, in this day and age, these explicit beliefs still exist, but what scares me more are all the implicit unconscious biases that affect all women not only in surgery but in medicine as well.

Looking back, 2018 is a year of beginning difficult conversations about physician and surgeon wellness, burnout, and gender bias. What’s obvious is that there is a hell of a lot of work to do. But change is slowly starting. We are now recognizing what the issues are, and the next step is to take action. It’s difficult to steer big ships, but there is an active community investing in strategies to improve the cultural scope of surgery and supporting and valuing women and what they have to offer.

References

Magudia K et al. JAMA. 2018;320(22):2372-4.

Meyerson SL et al. J Surg Educ. 2017;74(6):e111-18.

Dr. Drudi is a vascular surgery resident at McGill University, Montreal, and the resident medical editor of Vascular Specialist.

 

As I reflect upon the past year, 2018 has certainly made a mark for addressing burnout among medical professionals, enforcing wellness, and targeting implicit and explicit gender bias in medicine and surgery.

Dr. Laura Drudi
Dr. Laura Drudi

Looking back, I entered surgery with a dream to change the culture of surgery. I knew I didn’t fit the traditional mold of an aggressive or arrogant surgeon. But I thought that my empathetic, open, and compassionate ways may spark a change in paradigm for that traditional surgical ideology. However, what I encountered as I made my way on this long, ever-winding journey was a system, culture, and tradition that beats you down, and what I thought were my strengths were quickly turned into weaknesses. As I grew and matured, this loss of identity in a culture of depersonalization surrounded by gender bias, for me, was a perfect recipe leading straight to burnout. However, this was an impetus for change, to be that voice and spark for a cultural transformation of surgery and for the women who work in the specialty.

More women are entering medical and surgical specialties. However, despite the advances made there are still clear gender-based disparities influencing overall wellness and work satisfaction. For instance, a study by Meyerson et al. demonstrated that female residents receive less operating room autonomy than male ones. I see it daily within my own curriculum and in observing other female residents in other surgical specialties. Furthermore, female residents are less often introduced by their physician titles, compared with their male counterparts, are often confused as nonphysicians, and are perceived as being less competent. This influences, to no small extent, overall confidence. It’s discouraging and disheartening to have worked so hard and yet still be treated in a sexist paradigm. And to top it all off, female physicians face a motherhood penalty.

In a recent study by Magudia et al., out of 12 top medical institutions that provided maternity leave, only 8 did so for residents with a grant total of 6.6 weeks on average. Furthermore, women with children or women who plan to have children have constrained career opportunities and are less likely to get full professorship or leadership positions. Anecdotally, a surgeon in passing semijokingly told me that if I were to take a specific academic vascular position, I may have to sign an agreement not to get pregnant ... probably not the job for me.

It’s appalling that, in this day and age, these explicit beliefs still exist, but what scares me more are all the implicit unconscious biases that affect all women not only in surgery but in medicine as well.

Looking back, 2018 is a year of beginning difficult conversations about physician and surgeon wellness, burnout, and gender bias. What’s obvious is that there is a hell of a lot of work to do. But change is slowly starting. We are now recognizing what the issues are, and the next step is to take action. It’s difficult to steer big ships, but there is an active community investing in strategies to improve the cultural scope of surgery and supporting and valuing women and what they have to offer.

References

Magudia K et al. JAMA. 2018;320(22):2372-4.

Meyerson SL et al. J Surg Educ. 2017;74(6):e111-18.

Dr. Drudi is a vascular surgery resident at McGill University, Montreal, and the resident medical editor of Vascular Specialist.

Publications
Publications
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica

Taking a leap of faith

Article Type
Changed
Wed, 04/03/2019 - 10:28

 

After a grueling first two years of surgical residency, I welcomed with open arms my surgical research years. Junior surgical residency was arguably the toughest years of my training to date. Long hours at the hospital; the uncertainty of being called in to the hospital when on-call, which led to chronic anxiety and at times insomnia; and the pressures I put on myself to excel in all aspects of my training were draining, to say the least.

Of course, when it came time to leave my clinical responsibilities and pursue my Master’s degree, I was overcome with relief. First, I got my life back on track, leading a life of optimal nutrition, physical activity, and sleep and exploring different horizons in surgery.

Dr. Laura Drudi
Dr. Laura Drudi
Well, after roughly two years, this time is coming to a bittersweet close. I have learned many lessons over these months, which I hope to use during the next transition of my surgical education. First, this period of time renewed my passion for vascular surgery, making me yearn to come back to my clinical responsibilities with a new perspective. It’s easy to take for granted during the routine of our days how fortunate we are in our positions to provide the broad range of vascular care to our patients. It’s quite easy to forget the most humbling fact that we provide limb- and life-saving interventions to our patients in their most vulnerable of times.

Second, this time allowed me to grow as a person, learning techniques to remain calm in the face of adversity, to take at least 10 minutes a day for mindfulness, and to be cognizant and gauge when I am creeping upon that tipping point. I believe the key to success and happiness is to keep re-evaluating and being honest with ourselves, our happiness, our stresses, and our anxieties and to reach out to pillars of support, whoever they may be.

And finally, we are fundamentally teachers and inspirations to the next generation of surgeons who will follow in our footsteps. By being open, encouraging, and sharing our enthusiasm for our specialty, our patients, and our research, we may see the seeds of the future flourish under our wings.

That being said, I am terrified of returning to vascular surgery. I know it will be a challenge transitioning to senior resident, and I am scared that the progress I made over these years in terms of wellness and wellbeing will regress; however, in the end, I have to take a leap of faith and hope it all pulls together ... seamlessly.
 

Dr. Drudi is a vascular surgery resident at McGill University, Montreal, and the resident medical editor of Vascular Specialist.

Publications
Topics
Sections

 

After a grueling first two years of surgical residency, I welcomed with open arms my surgical research years. Junior surgical residency was arguably the toughest years of my training to date. Long hours at the hospital; the uncertainty of being called in to the hospital when on-call, which led to chronic anxiety and at times insomnia; and the pressures I put on myself to excel in all aspects of my training were draining, to say the least.

Of course, when it came time to leave my clinical responsibilities and pursue my Master’s degree, I was overcome with relief. First, I got my life back on track, leading a life of optimal nutrition, physical activity, and sleep and exploring different horizons in surgery.

Dr. Laura Drudi
Dr. Laura Drudi
Well, after roughly two years, this time is coming to a bittersweet close. I have learned many lessons over these months, which I hope to use during the next transition of my surgical education. First, this period of time renewed my passion for vascular surgery, making me yearn to come back to my clinical responsibilities with a new perspective. It’s easy to take for granted during the routine of our days how fortunate we are in our positions to provide the broad range of vascular care to our patients. It’s quite easy to forget the most humbling fact that we provide limb- and life-saving interventions to our patients in their most vulnerable of times.

Second, this time allowed me to grow as a person, learning techniques to remain calm in the face of adversity, to take at least 10 minutes a day for mindfulness, and to be cognizant and gauge when I am creeping upon that tipping point. I believe the key to success and happiness is to keep re-evaluating and being honest with ourselves, our happiness, our stresses, and our anxieties and to reach out to pillars of support, whoever they may be.

And finally, we are fundamentally teachers and inspirations to the next generation of surgeons who will follow in our footsteps. By being open, encouraging, and sharing our enthusiasm for our specialty, our patients, and our research, we may see the seeds of the future flourish under our wings.

That being said, I am terrified of returning to vascular surgery. I know it will be a challenge transitioning to senior resident, and I am scared that the progress I made over these years in terms of wellness and wellbeing will regress; however, in the end, I have to take a leap of faith and hope it all pulls together ... seamlessly.
 

Dr. Drudi is a vascular surgery resident at McGill University, Montreal, and the resident medical editor of Vascular Specialist.

 

After a grueling first two years of surgical residency, I welcomed with open arms my surgical research years. Junior surgical residency was arguably the toughest years of my training to date. Long hours at the hospital; the uncertainty of being called in to the hospital when on-call, which led to chronic anxiety and at times insomnia; and the pressures I put on myself to excel in all aspects of my training were draining, to say the least.

Of course, when it came time to leave my clinical responsibilities and pursue my Master’s degree, I was overcome with relief. First, I got my life back on track, leading a life of optimal nutrition, physical activity, and sleep and exploring different horizons in surgery.

Dr. Laura Drudi
Dr. Laura Drudi
Well, after roughly two years, this time is coming to a bittersweet close. I have learned many lessons over these months, which I hope to use during the next transition of my surgical education. First, this period of time renewed my passion for vascular surgery, making me yearn to come back to my clinical responsibilities with a new perspective. It’s easy to take for granted during the routine of our days how fortunate we are in our positions to provide the broad range of vascular care to our patients. It’s quite easy to forget the most humbling fact that we provide limb- and life-saving interventions to our patients in their most vulnerable of times.

Second, this time allowed me to grow as a person, learning techniques to remain calm in the face of adversity, to take at least 10 minutes a day for mindfulness, and to be cognizant and gauge when I am creeping upon that tipping point. I believe the key to success and happiness is to keep re-evaluating and being honest with ourselves, our happiness, our stresses, and our anxieties and to reach out to pillars of support, whoever they may be.

And finally, we are fundamentally teachers and inspirations to the next generation of surgeons who will follow in our footsteps. By being open, encouraging, and sharing our enthusiasm for our specialty, our patients, and our research, we may see the seeds of the future flourish under our wings.

That being said, I am terrified of returning to vascular surgery. I know it will be a challenge transitioning to senior resident, and I am scared that the progress I made over these years in terms of wellness and wellbeing will regress; however, in the end, I have to take a leap of faith and hope it all pulls together ... seamlessly.
 

Dr. Drudi is a vascular surgery resident at McGill University, Montreal, and the resident medical editor of Vascular Specialist.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME