Lily Tung1, Andrea M Long, Stephanie Bonne, Esther S Tseng, Brandon Bruns, Bellal Joseph, Brian H Williams, Deborah Stein, Julie A Freischlag, Nicole Goulet, Cathleen Khandelwal, Elizabeth Kiselak, Mark Hoofnagle, Rondi Gelbard, Rishi Rattan, D'Andrea Joseph, Andrew Bernard, Tanya L Zakrison. 1. From the Division of Trauma (L.T.), Vancouver General Hospital, Vancouver, British Columbia, Canada; Acute Care Surgery(A.M.D.), University of California San Francisco Fresno, Fresno, California; Division of Trauma and Surgical Critical Care (S.B.), Rutgers New Jersey Medical School, Newark, New Jersey; Division of Trauma, Critical Care, Burns, and Emergency General Surgery, Department of Surgery (E.S.T.), MetroHealth Medical Center, Cleveland, Ohio; R Adams Cowley Shock Trauma Center (B.B.), University of Maryland, Baltimore, Maryland; Trauma, Critical Care, Burn and Emergency Surgery (B.J.), University of Arizona College of Medicine, Tucson, Arizona; Section for Trauma and Acute Care Surgery (B.H.W., T.L.Z.), The University of Chicago Medicine, Chicago, Illinois; Department of Surgery (D.S.), University of California San Francisco, San Francisco, California; CEO Wake Forest Baptist Health, Dean Wake Forest School of Medicine (J.E.F.), Winston-Salem, North Carolina; Division of Trauma, Critical Care and Emergency of Surgery (N.G.), NYU Langone, New York University School of Medicine, New York, New York; Department of Surgery (C.K.), Cleveland Clinic, Cleveland, Ohio; Department of Trauma, Surgical Critical Care and Injury Prevention (E.K.), Hackensack University Medical Center, Hackensack University Medical Center, Hackensack, New Jersey; Division of Acute and Critical Care Surgery (M.H.), Washington University in St. Louis, St. Louis, Missouri; Division of Trauma (R.G.), University of Alabama at Birmingham, Birmingham, Alabama; Division of Trauma Surgery and Critical Care (R.R.), DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida; Division of Trauma and Acute Care Surgery, Department of Surgery (DA.J.), NYU Winthrop Hospital & NYU Long Island School of Medicine, Mineola, New York; Acute Care Surgery (A.B.), University of Kentucky College of Medicine, Lexington, Kentucky.
Abstract
BACKGROUND: Inequity exists in surgical training and the workplace. The Eastern Association for the Surgery of Trauma (EAST) Equity, Quality, and Inclusion in Trauma Surgery Ad Hoc Task Force (EAST4ALL) sought to raise awareness and provide resources to combat these inequities. METHODS: A study was conducted of EAST members to ascertain areas of inequity and lack of inclusion. Specific problems and barriers were identified that hindered inclusion. Toolkits were developed as resources for individuals and institutions to address and overcome these barriers. RESULTS: Four key areas were identified: (1) harassment and discrimination, (2) gender pay gap or parity, (3) implicit bias and microaggressions, and (4) call-out culture. A diverse panel of seven surgeons with experience in overcoming these barriers either on a personal level or as a chief or chair of surgery was formed. Four scenarios based on these key areas were proposed to the panelists, who then modeled responses as allies. CONCLUSION: Despite perceived progress in addressing discrimination and inequity, residents and faculty continue to encounter barriers at the workplace at levels today similar to those decades ago. Action is needed to address inequities and lack of inclusion in acute care surgery. The EAST is working on fostering a culture that minimizes bias and recognizes and addresses systemic inequities, and has provided toolkits to support these goals. Together, we can create a better future for all of us.
BACKGROUND: Inequity exists in surgical training and the workplace. The Eastern Association for the Surgery of Trauma (EAST) Equity, Quality, and Inclusion in Trauma Surgery Ad Hoc Task Force (EAST4ALL) sought to raise awareness and provide resources to combat these inequities. METHODS: A study was conducted of EAST members to ascertain areas of inequity and lack of inclusion. Specific problems and barriers were identified that hindered inclusion. Toolkits were developed as resources for individuals and institutions to address and overcome these barriers. RESULTS: Four key areas were identified: (1) harassment and discrimination, (2) gender pay gap or parity, (3) implicit bias and microaggressions, and (4) call-out culture. A diverse panel of seven surgeons with experience in overcoming these barriers either on a personal level or as a chief or chair of surgery was formed. Four scenarios based on these key areas were proposed to the panelists, who then modeled responses as allies. CONCLUSION: Despite perceived progress in addressing discrimination and inequity, residents and faculty continue to encounter barriers at the workplace at levels today similar to those decades ago. Action is needed to address inequities and lack of inclusion in acute care surgery. The EAST is working on fostering a culture that minimizes bias and recognizes and addresses systemic inequities, and has provided toolkits to support these goals. Together, we can create a better future for all of us.
Authors: Esther S Tseng; Brian H Williams; Heena P Santry; Matthew J Martin; Andrew C Bernard; Bellal A Joseph Journal: Curr Trauma Rep Date: 2022-09-05