Taking Action to Bring OMS Women Into Leadership: Elaine A. Steubner Scholars Award-Winning Essay

This essay is the winner of the 2024 Elaine A. Steubner Scholars essay contest.

Our specialty is facing a challenge: how can we advance women into leadership positions? I take joy in the fact that this problem is now being tackled. It may seem disheartening that this problem even exists and needs to be addressed. However, it’s a step ahead of the need to recruit women only at the resident level. Although this remains a challenge, we now have many women who have long served the specialty and are very deserving of leadership roles. Reaching this important final step — of placing women into leadership positions — signifies we are finally resolving disparities. Women are stepping closer to becoming truly equal in our specialty.

A Need for Defined Goals

Still, the challenge and question remains: how can we advance women into OMS leadership positions? To begin contemplating how to solve this considerable problem, we need to first reflect on where we have been, where we are now, and specify what exactly is our goal. “Increasing the presence of women in leadership” is simply too ambiguous of a concept. Furthermore, actionable steps and goals are needed for us to be able to measure and track any discernable progress for women. Especially when we realize that all the progress women have made in medicine — and the tremendous advancements we have made thus far — spans over the course of now 175 years since the first female graduated from medical school: Dr. Blackwell. Setting pragmatic goals within a realistic timeline is necessary, as this progress clearly did not happen overnight. Most importantly, we must realize that each step we take now, no matter how small, is an investment that will compound over decades, and benefit likely not ourselves but those who come after. As surgeons, this lack of immediate change can be disheartening, but it is important we can prioritize future women and our specialty before ourselves.

Where Are We Now?

I would summarize “where we are now” as “we currently have numerous examples that women are capable of being strong, inspiring, effective, and skilled leaders in OMS.” We also have a lot of opportunity for growth, not only for women, but also for other underrepresented minorities in the profession. However, we have been making steady progress. Being a surgeon inherently means being a leader, and there is an ever-growing population of capable women leaders we can choose from. Our task is to identify these women and start them on the path to leadership.

Unfortunately, this path is long, so the earlier we can find opportunities for women in their careers, the better. During early career, if someone can gain skills and experience, they will be much more likely and able to take on substantial roles in leadership when they are becoming mid- to late-career. Because our numbers have been so small for so long, there has been such a large burden placed on only a few women holding leadership positions in OMS. If we don’t bring reinforcements soon, those bearing much of the work could burn out, and we will lose the ground that was hard fought to gain. It is important now for all women interested and qualified to step up, and for women in OMS to support each other. Women succeeding is OMS is not a zero-sum game, and any victory helps all other women in our field.

Specifically in OMS, there has been notable progress, but women clearly lack the presence in leadership that matches their numbers in general membership. Our national organization AAOMS has never had a women president, and only one woman ever on the board of trustees. ABOMS currently has zero active women on the board and only one president in 2011. ACOMS can be applauded with one third of its board being women, and a recent history of women presidents. These numbers are closer in line with American College of Surgeons, which has been consistently electing women presidents since the 2010s. As a specialty, we’ve succeeded in boosting enrollment of women in residency, and it could be assumed based on our increase in membership alone, that in time, there will be more women in leadership following the path of similar specialties.

Barriers for Women Leaders

Still, there are barriers to entry for women, which stay rather unchanged over time. The topics of gender bias in promotion, salary inequity, professional isolation, bullying, sexual harassment, and lack of recognition are all well documented in research studies. Furthermore, specifically in our specialty many panels and committees are filled by invitation or votes by peers who are majority male, which can exacerbate the problem. A dedication to broadly advertising opportunities to all members, filling positions based on merit alone, and transparency in the selection process would all help move us toward gender parity. This fear of changing the status quo hurts not only women in leadership but our specialty in general. Women applying for leadership positions need to have all the necessary qualifications and move through all the proper channels. Lowering the bar to funnel women to the top would simply be setting ourselves up for failure. Still, the problem exists that women are not given as many important lower-level opportunities that then help with promotion to more significant leadership positions.

Finally, we must outline what exactly are our goals for women in leadership, e.g., securing a corresponding number of women in leadership that is in proportion to the number of women members in our field. Then furthermore defining “leadership positions” as seats on national committees and boards, and in academic leadership positions (full professorship, program director, and chair).

Using Goals to Drive Action

Based on our goals and progress thus far, I propose the following actionable items:

Action 1: Women need help catching up to men in leadership skills and experience. Investing now into the leadership skills of women is my solution.

Women haven’t been in leadership positions until recently, and only a very small number of women have achieved the highest levels of leadership. Also, we have not reached the highest levels just yet. If women are going to be successful, they need the roadmap and the tools to be able to navigate this path. One way to give women both experience and skills to be future leaders are surgical leadership programs. Another option is master-level programs in business, leadership, and education. I propose creating a scholarship for women to enroll in one of these programs that can demonstrate a commitment to being a future leader. This could be accomplished through collaboration with an organization like ACOMS or the OMS Foundation through directed donations to this scholarship program so that it could be maintained long term. Though progress would not be immediate, if one woman a year could have this opportunity there could be real measurable results in 10 years.

Action 2: OMS leadership positions need to be filled based on merit. There needs to be transparency in how to apply, and who is chosen and why.

Anonymous voting from a very strong majority group can easily result in ingroup bias, causing a lack of diversity on the team. Scoring candidates and open discussion could help make this process more transparent without mandating quotas.

Action 3: We need to support true diversity, not just for women. We need to reject the all-white “manel” (a panel with all men) and make efforts to have diversity regarding gender, ethnicity, geography, age, etc., as we have qualified surgeons of every background that have something to contribute.

Diversity on panels and committees at AAOMS is a measurable and trackable metric that we could follow over time to track progress to our goals. Furthermore, bringing in new speakers and giving them experience early will only build a better foundation for our future.

Action 4: There should be women in OMS leadership, mentorship, sponsorship, and recruitment.

Current leaders, both men and women need to make an effort to teach the next generation of women leaders. As we now have reached a sizeable number of members, women in leadership could be its own special interest group. Or a focused small meeting to teach leadership skills could be held just for women.

Action 5: Women should seek leadership positions outside of OMS.

There are many other organizations that women can join and assume leadership positions in that are not necessarily OMS-specific, but relevant or adjacent to our field. The ADA, ADEA, ACS are just some examples. This is both a great way to gain leadership experience as well as promote our specialty in the dental and medical community.

In conclusion, women in surgery aspiring for leadership positions may face challenges their male counterparts do not, including explicit gender discrimination and implicit gender bias. To achieve gender parity in our field, we need to lift up the women who have made incredible advancements towards this goal already and support the next generation of women to lead. This process will be slow, as our past progress is generally measured over the course of decades, and not year-to-year. Investing time and money into the next generation of leaders now is our best chance of promoting women in our specialty and achieving true equality in OMS.