Joana Letícia Spadoa (1), Amanda Alvesz (1), Ana Luíza Konopka (1), Candida Assis Brasil (1), Gabriela Brandão (1), Gabriela Salzano (1), Júlia Iaroseski (1), Sarah Motter (1).
1 – Association of Women Surgeons’ Student Chapter at Federal University of Health Sciences of Porto Alegre (UFCSPA)
The presence of inspiring people motivates our path in life, both professionally and personally. Meeting professionals that are an inspiration for us is a key way to generate models of who we want to be. In a society still marked by sexism, it is very propelling for girls and young females to know the history of women. We find great examples daily in our families, friends, colleagues, teachers, tutors, etc. However, for female academics who dream of becoming surgeons, there is often a lack of female surgeon models. In Brazil, the voice that asks for "scalpel, please" is still mostly from a man. The literature shows that one of the several factors influencing women's choice in the surgery field is having female surgeon models during their training (1). Thus, our goal is to discuss the importance of generating role models for young female students who yearn to be surgeons.
The first woman who graduated in Medicine in Brazil was Rita Lobato Lopes, in 18872. The first woman to enter the Brazilian College of Surgeons -– the main surgical society in Brazil -– was Merisa Braga De Miguez Garrido, in 19592. More than 60 years later, like Merisa, women who choose to be surgeons are still pioneers. Data from the 2020 Medical Demography Report showed a very low female representation rate in surgical specialties in Brazil (3). Of the 34,479 general surgeons, 7,605 were women (22.1%) (3). In some specialties, female representation is less than 10%. These include Neurosurgery (8%), Orthopaedics (6.5%), and Urology (2.3%) (3). Associated with this, we see few women as Professors of surgery at universities, as leaders in surgical societies, or as Heads of research in the surgical field. Consequently, academics interested in surgery often have little contact with female surgeons throughout their training, which makes it more difficult for them to imagine themselves in this career.
On the other hand, around the world, initiatives aimed at encouraging women surgeons have brought female medical students closer to surgery. The emergence and strengthening of women surgeon’s societies such as the Association of Women Surgeons (AWS) are essential for establishing an international community seeking gender equity. In our experience, developing an AWS chapter at our University – the Federal University of Health Sciences of Porto Alegre (UFCSPA) – has allowed us to integrate a global network of female surgeons. This is the starting point for generating several educational and research projects to close the gender gap in surgery in Brazil. Furthermore, actions promoted by the Gender Equity Initiative in Global Surgery (GEIGS) are fundamental for disseminating the debate on issues related to gender disparities in surgery worldwide.
Additionally, the internet has played an important role in bringing medical students closer to the surgery field. Through various social networks, it has become possible to meet and interact with surgeons from all over the globe. With that, we overcome barriers such as distance and establish connections. Now, medical students from Brazil, like us, can contact inspirational surgeons on the other side of our country or the world. Also in social media, movements like #ILookLikeaSurgeon gave visibility to the discussion of gender inequality in surgery throughout social networks and showed that women are “the face of surgery” undoubtedly. Furthermore, with the transition to online backgrounds because of the COVID-19 pandemic, we were able to participate in great international events and meet inspiring women surgeons that we never had the opportunity before, which was an amazing experience to us. Thus, the internet has been and should keep being a facilitator of our engagement for women in surgery.
Therefore, we can see that a lot has already been done, but there is still a lot to do for a bigger representation of women in surgery and the generation of role models in this area. We need to strengthen this international community to focus on bringing female academics closer to surgery and we need more initiatives to discuss these issues around the world. We want to be surrounded by female surgeons in the classrooms we attend, in the events we participate in, in the operating rooms we enter, in the research we work on. Meeting and being close to female surgeons makes this trajectory palpable and possible to achieve. With that, we have the opportunity to establish a bond, have a mentor, and possibly work with these surgeons for a long time. Notwithstanding, it is important to mention that the benefits of a bigger representation of women in surgery go beyond trainees and us students and reach healthcare as a whole. The literature shows that diversity in the workplace is associated with an improvement in performance and patient health outcomes (4).
To conclude, we want to congratulate the hardship of women surgeons across the world for being a great inspiration for all of us medical students who aspire to become surgeons. Your trajectory motivates us. We also want to empower more students to become the surgeons they always dreamed of. Join us in this worldwide community dedicated to improve the representation of women in surgery. As the voices of the future of the surgery, we hope to be the role models to inspire others and be the female voice that asks for “scalpel, please”.
* References:
1. Wirtzfeld DA. The history of women in surgery. Can J Surg. 2009;52(4):317-320.
2. Dantas, FLL; Santos, EG; Women in Surgery in Brazil. Available: <https://www.womensurgeons.org/news/523802/Women-in-Surgery-in-Brazil-.htm>
3. Scheffer, M. et al., Demografia Médica no Brasil 2020. São Paulo, SP: FMUSP, CFM, 2020. 312 p. ISBN: 978-65-00-12370-8
4. Gomez LE, Bernet P. Diversity improves performance and outcomes. J Natl Med Assoc. 2019 Aug;111(4):383-392. doi: 10.1016/j.jnma.2019.01.006. Epub 2019 Feb 11. PMID: 30765101.