#ILookLikeASurgeon Gets New Boost From New Yorker Cover

Alicia Ault

April 20, 2017

A single tweet on April 4 breathed massive new life into a 2-year-old social media campaign originally conceived to promote diversity in the surgical field and to humanize those who toil in the operating room.

On that April day, an endocrine surgeon convinced three colleagues at the American Association of Endocrine Surgeons meeting to take a selfie that replicated the cover of the April 3 New Yorker magazine. Artist Malika Favre had portrayed four women in scrubs peering down at a patient, an operating room light fixture looming behind them.

"I was very taken aback by the fact that there were all women on the cover," Susan Pitt, MD, MPHS, an assistant professor of endocrine surgery at the University of Wisconsin School of Medicine and Public Health, in Madison, told Medscape Medical News. She also loved the art itself, and thought it would be nice to replicate the scene and share it on social media.

Purposely using the hashtag #ILookLikeASurgeon, Dr Pitt fastened on to a campaign started by a surgical resident in 2015 to break down preconceived notions and attract more women and minorities to surgery.

Dr Susan Pitt, on the left, with fellow colleagues.

Dr Pitt issued the #NYerORCoverChallenge a few days after her initial tweet, asking women to make their own version of the cover photo. In just a few weeks, #ILookLikeASurgeon was tweeted out more than 18,000 times, generating an estimated 180 million impressions, according to the tracking site Symplur.

Tweets using #ILookLikeASurgeon and #NYerORCoverChallenge have been issued from every continent except Antarctica, Dr Pitt said. Instagram and Facebook users are also employing the hashtags, though in lesser numbers.

 

The campaigns have been covered by the Washington Post, the New Yorker, CNN, USA Today, the New York Times, Buzzfeed, the Huffington Post, Amy Poehler's Smart Girls blog, Indian Woman blog, In Style, CBS, the Independent, Hungary Today, and hundreds of local newspapers and TV stations in the United States and around the world.

Dr Pitt said the response has been overwhelmingly positive. Almost no one has said, "Why don't you stop taking pictures and take care of patients," she told Medscape Medical News.

When she made that first tweet, she had no idea it would snowball as much as it did, but she said, "I'm happy to be the face of helping close the gender gap and the gender bias issue."

Heather Logghe, MD, the surgical resident who started #ILookLikeASurgeon, said she's happy with the new energy the New Yorker cover has brought to her hashtag — even though the cover challenge focuses on female empowerment. She created her hashtag to humanize surgeons — inviting them to tweet photos of themselves exercising or with their children — and also to show that surgeons could be something other than a straight white man.

Dr Heather Logghe, the originator of the original hashtag. Courtesy of Dr Logghe

Dr Logghe, who has completed 2 years of surgical residency and, after a brief break to have her second child, is now going back to residency, has been researching social media. It "harnesses the power of images to change cultural expectations," Dr Logghe told Medscape Medical News.

The viral response to the New Yorker cover "speaks to the need," for equality and respect, said Dr Logghe, who added that sexism seems to be alive and well in surgery.

"I dream of the time when feminist hashtags are no longer needed," she said.

The Gender Gap

Sareh Parangi, MD, FACS, vice president of the Association of Women Surgeons, dreams of that day, too, but said that the gender gap in surgical leadership and pay is still so wide that it requires a female-focused social media campaign and advocacy effort.

The AWS Twitter handle @WomenSurgeons has been one of the top influencers of the #ILookLikeASurgeon and #NYerORCoverChallenge, issuing thousands of tweets and retweets and generating millions of impressions. Dr Parangi, who directs the Endocrine Surgery Fellowship at Massachusetts General Hospital, took a cover shot with nine surgery residents and Pat Numann, MD, the founder of AWS.

Younger women tell her they don't need to join AWS, but down the road, when they're trying to break into a leadership position, they come back, Dr Parangi said.

#ILookLikeASurgeon, and the New Yorker challenge have helped bring thousands of new members to AWS and "get the word out that surgery is very open to women, that women get a lot out of it, and that it's a satisfying career," Dr Parangi told Medscape Medical News.

Even so, women don't climb the ranks the way male colleagues do, and "there's a significant pay gap," she said. The AWS reports for instance, that women in private surgical practice earn vastly less than male peers, and "women in academic medicine earn less than men even after adjustment for factors such as age, years of experience, specialty, reported work hours, research productivity, and faculty rank."

Many men in the surgical field aren't satisfied with the gender gap, and have actively embraced #ILookLikeASurgeon and #NYerORCoverChallenge. The University of Michigan's surgery department tweeted on April 14 that its chairman, Michael W. Mulholland, MD, said he's aiming to make half his department female. The department also is challenging male surgeons to show their support for female colleagues through the #HeForShe hashtag.

Thoracic surgeon Thomas Varghese Jr, MD, is among the top 10 influencers for both #NYerORCoverChallenge and #ILookLikeASurgeon.

These campaigns "are critically important for us — not only to raise awareness that we need to do a better job embracing diversity, but also for the future of our specialty," said Dr Varghese, head of general thoracic surgery and program director for the cardiothoracic residency at the University of Utah School of Medicine in Salt Lake City.

"Women just need to see positive or great examples of women who have been successful," Dr Varghese told Medscape Medical News. The same is true for minorities, he said, adding that he believes the hashtags have helped create more of a sense of community in surgery.

He retweets to show support, to network, and to connect with people, especially potential recruits, who tend to be more active on social media, he said. Dr Varghese said he thinks individual connections will also help sustain the Twitter campaigns. He'd like to see the tweets morph into a sharing of successful strategies for breaking stereotypes and barriers.

Youthful Enthusiasm

Even the most cursory glance at tweets for #ILookLikeASurgeon and #NYerORCoverChallenge reveal that legions of young women have stepped up to show that they're giving surgery a go, or to express interest in a field that they may not have considered before. Some said that organizations that participated were more interesting to them.

"I may have to start factoring programs' #NYerORCoverChallenge photos into my fellowship rank list," tweeted general surgery resident Andrea Merrill (@anjlm7) on April 17.

Folasade Imeokparia, MD, tweeted out a New Yorker cover on April 17, featuring her with six other surgical residents, almost all women of color.

Dr Folasade Imeokparia, wearing the gloves, shown with medical colleagues. Courtesy of Dr Imeokparia

Dr Imeokparia, a fourth-year surgical resident at Ohio State University, James College of Medicine, Columbus, said the program director is already planning on using the Twitter photo to help recruit minorities. Many women and minorities don't understand the careers that are open to them, "because they haven't seen people in those roles who are women or minorities," Dr Imeokparia told Medscape Medical News.

Before taking part in the #NYerORCoverChallenge, she hadn't heard of #ILookLikeASurgeon. Dr Imeokparia said that although the Twitter campaigns may have a limited shelf-life, they are starting conversations and inspiring action. She's applying for a fellowship in breast surgery, with the ultimate goal of addressing outcome disparities for minority women.

Hilary Caitlyn McCrary, a fourth-year medical student at the University of Arizona, in Tucson, told Medscape Medical News that the New Yorker cover and the subsequent tweets are "a symbol that women have gained more equality in the field of surgery."

McCrary will be doing a residency in otolaryngology-head and neck surgery at the University of Utah, and will likely pursue a fellowship as well.

Surgery was attractive because of the hands-on experience, and "the immediate satisfaction that comes with fixing a problem in the operating room," she said. And, she added, "I was drawn to the personalities in surgery; they were assertive and knew what they wanted."

At least one female classmate saw surgery as an impossibility for any woman who wanted to have children, she said, adding that men are not exempt from that notion, which she said stigmatizes the field.

"I think it's important to surround yourself with people who understand there will be hard times in both your training and career, but that will stand by you and support you through the challenges you'll face," said McCrary.

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