Search

The taxing nature of surgery residency is well-documented in the literature, with residents demonstrating high rates of burnout, depression, suicidal thoughts, sexual harassment, and racial discrimination. Mentoring has been shown to improve camaraderie, address challenges of underrepresentation in medicine, and be associated with lower burnout. However, existing formal mentoring programs tend to be career-focused and hierarchal without opportunity to discuss important sociocultural issues. An innovative approach is needed to address these cultural and anthropological issues in surgery residencies while creating camaraderie and learning alternative perspectives across different levels of training. We sought to describe the framework we used to fill these needs by creating and implementing a novel mentoring program.A vertical, near-peer mentoring system of 7 groups was created consisting of the following members: 1 to 2 medical students, a PGY-1 general surgery resident, a PGY-4 research resident, and a faculty member. Meetings occur every 3 to 4 months in a casual setting with the first half of the meeting dedicated to intentional reflection and the second half focused on an evidence-based discussion regarding a specific topic in the context of surgery (i.e., burnout, discrimination, allyship, and finding purpose).Program implementation took place at the University of Michigan in Ann Arbor, MI.Medical students, general surgery residents, and general surgery faculty were recruited.We have successfully launched the pilot year of a cross-spectrum formal mentoring program in general surgery. This program emphasizes camaraderie throughout training while providing opportunities for evidence-based discussion regarding sociocultural topics. We have included increased opportunities for community inclusivity and mentoring while allowing trainees and faculty members to discuss sensitive topics in a supportive environment. We plan to continue developing the program with robust evaluation and to expand the program to other surgical specialties and to other institutions.

Background Academic health centers have promoted initiatives to improve diversity, equity and inclusion in medicine. Despite this emphasis, there has been limited discussion on practical strategies for navigating bias within academic surgery. This study analyzes experiences of confronting bias within the department of surgery at the University of Michigan. Materials and methods We conducted telephone interviews (n = 15) from January 2019 to January 2020 with surgeon volunteers at one academic institution. Two investigators conducted interviews following a semi-structured guide based on personal experiences with bias between healthcare workers with diverse identities. Interviews were conducted concurrently with thematic coding, coded independently by two investigators, and discussed until consensus was reached. Analysis proceeded following the inductive and comparative approach of interpretive description. Results The most common incidents of bias were based on gender and race. They occurred along numerous relationship axes, including physician-patient and resident-faculty. A critical factor in bias response was unambiguously recognizing bias. Responding to bias consists of timing and nature of the response, defined as when the subject responded relative to the incident and the actions done in response to the incident respectively. Barriers to bias response were fear of retribution and extensive energy required to respond. Institutional culture was important, specifically in representation and support from peers and administration. Conclusions This study probes deeper into equity and inclusivity in the academic field of surgery, offering insight into common barriers to confronting bias. Overall, these findings offer a basic framework for allies to identify bias and to partner with colleagues to address biases in a supportive manner.