We read with great interest the article by Siotos et al. entitled, “Increasing Diversity in Plastic Surgery,”1 and commend the authors for addressing the underrepresentation of women and minorities in plastic surgery. To effectively increase diversity, we must first appreciate the true complexity of what diversity entails. Traditional constructs of diversity are limited to basic observable traits such as race, ethnicity, and gender. Siotos et al. aptly stated that true diversity extends to include other qualities that characterize human experience, including religion, sexual orientation, and physical ability.1 Enhancing diversity in plastic surgery has important potential, not only by improving professional opportunities for the underrepresented, but also for patient care in treating the diverse population encountered daily.1
Although women compose half of all medical school graduates, only 14 percent of plastic surgeons and 32 percent of plastic surgery residents are women.2 Given the overwhelming percentage of female plastic surgery patients, we must target recruitment to reflect these patient dynamics.
Debra Johnson, M.D., the past president (in 2017) and only the second female president of the American Society of Plastic Surgeons, notes “women bring unique qualities to leadership, yet there remain barriers to gender equality,”2 and addresses concerns that women are underrepresented in plastic surgery because of different career aspirations, lack of confidence, paucity of mentors, and antiquated gender roles.3 Dr. Johnson states that women exhibit leadership styles associated with increased effectiveness and add diversity to decision-making, enhancing organizational performance, concluding that “a commitment to nurturing the leadership potential of all plastic surgeons will exponentially increase the creativity and influence of our specialty.”2 This challenge is not unique to medicine, and several lessons can be gleaned from large companies such as Google and Facebook as the diversity gap among female leaders continues. Sheryl Sanberg, chief operating officer of Facebook, attributes the slow progress to the “tyranny of low expectations” for women in senior leadership roles.4
Fostering a culture of women in leadership can have a trickle effect in engaging women and minority medical students interested in plastic surgery. To promote diversity, we need to nurture and expose an already diverse medical student pool to diverse mentors and teachers in the field. Earlier exposure and early establishment of mentorships in underrepresented groups either before or during early years of medical school are additional avenues to achieve these goals.5 Summer research programs and The Plastic Surgery Foundation Visiting Professors program can contribute to improving diversity by means of early exposure of minority groups to plastic surgery, and interactions between visiting professors and trainees. These avenues can help close the disparity gap.5 Fostering a culture of women, minorities, and other facets of diversity in plastic surgery leadership can have a trickle effect in promoting those with multifaceted diversity also in areas of culture, race, sexual orientation, religion, and so forth toward pursuing plastic surgery.
None of the authors has a financial interest to declare in relation to the content of this communication.
Rebecca L. DeSanti, B.A.
Lakshmi Nair, B.S.
Albany Medical College
Oluwaseun A. Adetayo, M.D.
Division of Plastic Surgery
Albany Medical College
1. Siotos C, Cui D, Lifchez SD, Cooney DS, Rosson GD, Cooney CM. Increasing diversity in plastic surgery. Plast Reconstr Surg. 2018;141:202e.
3. Silva AK, Preminger A, Slezak S, Phillips LG, Johnson DJ. Melting the plastic ceiling: Overcoming obstacles to foster leadership in women plastic surgeons. Plast Reconstr Surg. 2016;138:721729.
5. Adetayo OA, Adetayo O. Ethnic diversity remains scarce in academic plastic and reconstructive surgery. Plast Reconstr Surg. 2010;125:1848.