In the Loupes: Women in surgery

By Emina Huang, M.D.
Associate professor of colorectal surgery

With increased choices regarding health-care providers, there continues to be a paucity of women surgeons in academic health centers. Though women constitute 50 percent of medical school matriculants, and fully 30 percent of surgery residents, vanishingly few continue and are promoted into leadership positions in the academic health system.

Historically, the first fully accredited woman doctor in the United States was Elizabeth Blackwell, circa 1850. Ridiculed by others and later challenged by an eye infection necessitating her eye removal, she nevertheless went on to start her own clinic for women and children in New York. Later, she opened a medical school for the education of women.

As a resident at the Ohio State University, I was honored to be trained by Dr. Olga Jonasson, the first woman chair of any department of surgery in the United States. She was likewise challenged for her gender, and overcame these challenges with training, persistence and graciousness. She was tough but fair, she mentored all of her residents through their greatest achievements in residency, and she was flexible enough to come to appreciate that her resident children also had personal lives — she herself had made tremendous sacrifices for her achievements.

I had been told that she was not so enthusiastic about women residents who were married, lest a pregnancy interrupt their training. So it was with trepidation that I went to her office in March 1990 to tell her that I was pregnant. She was joyful and extremely supportive. Shortly after the baby was born in December 1990, she held our first-born son with pride.

Later, we jointly wrote both the maternity and paternity policies for residents to come, as well as a requested editorial, likely my most famous publication, titled, “A pregnant surgical resident! Oh My …” (JAMA, 1991). Later still, she told me that she told a group of her sage and mostly male colleagues that she deeply regretted not having a child. She has passed away in the last five years, but always gave me sound advice. When faced with a crossroads between choosing a career in private practice vs. academic practice, she told me, “Emina, you are uniquely suited for academic surgery ….”

The numbers of women surgeons in academic health centers are few, with even fewer at the most elite ranks. Per AAMC statistics, 20 percent of assistant professors and 14 percent of associate professors are female. Women account for a mere six percent of full professors! While I have alluded to challenges with identifying role models and sponsors above, other barriers include balancing not only work and family life, but also work and work life. These challenges exist in any two-career family. The sudden realization that balance is a ruse somehow frees you, yet we all strive for a bit of the “good life” and hope that with modern leadership, most of these barriers will disintegrate, leaving simple merit as the yardstick for advancement.

In 2008, my first year at UF, I applied for an industry grant and received $12,000 for outside speakers here targeting women surgeons and trainees. We had Meggin McIntosh (author of The PhD of Productivity) and Rayona Sharpnack (author of Trade Up!) come and speak with us, as well as some career development meetings. I also have offered more structured mentoring within our department.

As the most senior-ranking woman surgeon-scientist in UF’s department of surgery, I know that both the department and the institution are committed to promotion through multiple academic pathways, including education and service, in addition to research. The institution recognizes that to evolve and to advance in national rankings, all of our human resources need to be supported, and vetted at the highest level. This includes, of course, our women faculty, staff and students. The institution is shepherding formal programs in leadership and mentoring and, with investments in sponsorship, will permit synergistic alignment so that our precious resources will not view surgery as a career on the treadmill, but as a career with tremendous fulfillment, and joy!

“In the Loupes” is a monthly, online column meant to give readers insight into what it is like to be a surgeon today. Faculty members and residents from the University of Florida College of Medicine’s department of surgery write the columns based on their experiences in academic surgery. Views expressed here are not necessarily those of the department of surgery, the College of Medicine or the University of Florida.