Leadership in American Surgery: Women Are Rising to the top

Susan E. Pories, MD; Patricia L. Turner, MD; Caprice C. Greenberg, MD, MPH; Maya A. Babu, MD, MBA; Sareh Parangi, MD


Annals of Surgery. 2019;269(2):199-205. 

In This Article

Abstract and Introduction


Objective: To celebrate the increasing representation of women as leaders in American surgery and provide suggestions for increasing diversity in leadership.

Background: Women were barred from entering the practice of medicine or surgery until the mid 1800's when Elizabeth Blackwell led the way as the first woman admitted to medical school. Although the numbers of women practicing medicine and surgery have increased exponentially since Dr Blackwell graduated, the number of women in leadership positions has remained low until recently.

Methods: An analysis of the literature on the history of women in surgery and the websites of the major surgical societies.

Results: More women are now rising to leadership positions in surgery, both in academics and within surgical organizations. The American College of Surgeons and many other surgical societies, as well as an increasing number of academic departments of surgery have realized that women can be inspiring and capable leaders. However, increasing the number of under-represented minority women in leadership positions remains an opportunity for improvement.

Conclusions: Great progress has been made in the advancement of women into leadership positions in surgery. To continue this trend and increase the number of under-represented minority women in surgery will require attention to recruitment, mentorship, and sponsorship.


"Jonasson becoming chair showed us all that it could be you being chair"
—Dr Julie A. Freischlag

There is a respectful hush and a certain gravitas when surgeons and trainees sit side by side at surgical meetings paying rapt attention to the presidential speeches that define the vision of the society's leadership. What the trainees may have overlooked, but amazes and encourages those with a few more gray hairs, is the sudden spike in the number of women surgeons at the podium. The past 5 years have seen a marked and persistent tide of women rising into surgical leadership positions among our major surgical societies, with some even having several women presidents, such as the Association of Academic Surgery and the Society of University Surgeons. This momentum is also reflected at the American Board of Surgery and at academic institutions in the rising number of women serving as department chairs and in other senior leadership positions. The momentum and energy that this breakthrough has brought to our profession is nothing short of a watershed moment. Hopefully these advances of the past 5 years are just the beginning of things to come. One example of this transformational progress is a page on the Association of Women Surgeons (AWS) website set up to keep track of the number of women chairs of US Departments of Surgery, because it was finally approaching 10; now the AWS has a hard time keeping up, having to update the website constantly to make sure to include all the new women chairs, now over 20 and growing!

For many years, women have made major contributions to surgical societies and the Boards of the surgical specialties, yet they remained markedly under-represented in leadership circles.[1] There are now clear signs that senior leadership in American Surgery is starting to better reflect the membership of these societies and demonstrate to our future surgical workforce that women surgeons are a well-respected and integral part of the profession.

The importance of diversity (race, sex, sexual orientation, etc.) has been well-documented across a variety of disciplines. Businesses with more women and under-represented minorities on their staffs and in their boardrooms have better financial performance.[2] This may reflect a broader perspective and innovative approach to work that has been associated with groups embracing greater diversity. Similarly, in surgery, these new women leaders are catalysts for positive change in all areas of surgery, including the promotion of diversity and inclusion of more broadly, championing pay equity, and addressing issues such as well-being and burnout.

While there is still considerable distance to go to achieve full parity and equity for women and especially under-represented minority women, the pipeline is now more robust, with a steady stream of qualified individuals representing diverse demographics. As Dr Keith Lillemoe pointed out in his presidential speech at the 2017 American Surgical Association—"We as surgical leaders must recognize the importance that we can play in advancing the careers of our women faculty."[3] We recognize that we are making inroads because women in nonsurgical societies, from anesthesia to gastroenterology, have taken notice of our progress, and are asking for guidance. What follows is a brief overview of some of the pioneers who paved the way to a remarkable year when the new Executive Director and Chair of the American Board of Surgery, the President, the Chair of the Board of Regents, and the Chair of the Board of Governors of the American College of Surgeons are all women.