At the last in-person meeting of the American College of Surgeons in 2019, Jordan McKean noticed something missing.
Adrift in a sea of tables, booths and pamphlets, McKean noted several interest groups devoted to areas of diversity that the specialty found wanting — which is to say, most. But when she looked for one devoted to LGBTQ in surgery, she came up empty.
Later on, she brought it up with an older member.
“Well, I mean … are there even that many gay surgeons?” they replied.
It was one of McKean’s most formative memories as a medical student. Almost immediately after, interview season arrived and she attended meeting after meeting with residency programs across the country.
The exchange weighed heavily in the back of her mind as she approached each program with a set of questions designed to determine whether it was the place to launch her career as a surgeon — both in terms of skill, and in terms of mentorship.
In a new JAMA Surgery article detailing her experience in looking for a program transparent about its inclusivity, McKean, now a second-year resident at the UF Department of Surgery, discusses the LGBTQ diversity in surgery as it benefits not only clinicians, but patients as well.
“Historically, medicine has been a very non-diverse place,” McKean said. “And as a specialty, surgery tends to lag even more. More and more, however, I think people are going into medicine and expecting — wanting — to address these absences of representation, not only in personnel but in how we’re taught to provide patient care.”
And, as others have pointed out — it’s hard to become what you can’t see.
“It’s important to see people like yourself in positions you aspire to so you can think, ‘Okay, I’m going to be accepted in this field, in this area that I want to dedicate my life to,’” McKean said.
Residency is a crucial period in graduate medical education, demanding its patrons log 60- hour weeks while juggling patient care, research, personal lives, wellness and more. It pushes young surgeons to their limits, making their program choice a weighty decision. After all, when the going gets tough, you want the people you’re going with to be a good fit.
“Inevitably, there’s stress, long days and little sleep,” McKean reflected. “In the midst of that, why would you want to be in a place, or among people, you can’t fully be yourself around?”
After that fateful 2019 meeting, she recalled logging into Google Scholar and PubMed, curiosity piqued, for a cursory search regarding LGBTQ representation in surgery.
Her results — after just seconds — were scant. Five total.
“In some ways, that reflected what I had experienced in and of itself,” she said. “We weren’t talking about it. And we needed to.”
Most of the articles agreed that LGBTQ+ inclusion was necessary — but stopped short of offering concrete solutions on how this could be accomplished, or why it would improve the field of surgery.
Ideally, she said, her paper, a call to action regarding inclusivity in surgery, will become one of many. In it, she calls for the implementation of standardized LGBTQ+ training within medical and surgical education, extending to faculty, departmental and institutional leadership, continued advocacy for LGBTQ+ healthcare coverage, including coverage of gender affirming surgical care, promotion of mentorship and sponsorship opportunities for LGBTQ+ surgeons along the surgical pipeline, and more.
“Diversifying the workforce can only improve it,” McKean said. “Visibility is meaningful — and so is knowing you’ll be supported for who you are as a surgeon, fully. I’m at a program where I feel that way, but it shouldn’t be the exception. It should be the rule.”