2013 US population  (%)
2013 US medical school matriculants  (%)
2008 US surgical residentsa  (%)
2013 US surgical facultya  (%)
2013 US surgical tenured professorsa  (%)
The foregoing paragraphs suggest that one of the key barriers to having more URMM surgeons assuming leadership positions in academic surgery is the relatively small pool of candidates in the pipeline. For those URMM students who aspire to pursue a surgical career after graduating from medical school, they face a plethora of other barriers during surgical residency and as junior faculty that often impede their professional advancement along the academic ladder (Fig. 16.1). These include a lack of role models, a lack of mentorship, inadequate counseling, financial support and research infrastructure [5, 9, 12, 13].
Barriers that impede professional advancement of potential URMM leaders along the academic ladder and potential remedies
16.3 How Can One Overcome These Barriers?
Trailblazers such as Charles Drew and Samuel Kountz, and more recently, LaSalle Leffall, Claude Organ, and L.D. Britt, to name a few, have been able to overcome all sorts of barriers to reach the apogee of American Surgery. These giants of American surgery, who happen to be from an URMM, share one common thread: they personified excellence. According to an anonymous writer, excellence is the “the result of caring more than others think is wise, risking more than others think is safe, dreaming more than others think is practical, and expecting more than others think is possible.” Indeed, these pioneers exemplified the notion that excellence will silence all critics. Undoubtedly, they would be inducted into the “Hall of Fame of American Surgery” if such an entity existed.
Charles R. Drew epitomized excellence. His brilliant work while a research fellow and surgery resident at Columbia University Presbyterian Hospital helped to elucidate the causative factors in the pathogenesis of shock. In conjunction with John Scudder, he studied the efficacy of blood plasma in the treatment of secondary shock. It is widely held that his doctoral thesis on “Banked Blood” not only provided the basis for separating the components of whole blood, such as plasma from the red cells, but also may have led to the establishment of the modern blood bank . As such, he was appointed director of the first American Red Cross Blood Bank at Presbyterian Hospital.
Similarly, Samuel L. Kountz distinguished himself as a superb academic surgeon. His seminal work on the “Mechanism of Rejection of Homotransplanted Kidneys” was published in Nature in 1963 . In addition to serving as Chair of the Department of Surgery at the State University of New York at Downstate, he held numerous leadership positions in prestigious academic surgical societies, ultimately culminating with his ascendancy to the presidency of the Society of University Surgeons in 1975. Just like Charles Drew, an untimely death abbreviated his meteoric rise in academic surgery, which, almost certainly, would have taken him to the pinnacle of American surgery, the presidency of the American College of Surgeons.
This distinction, President of the American College of Surgeons, belongs to LaSalle D. Leffall, Jr., the first African American or URMM to hold this esteemed and revered position. Dr. Leffall’s brilliance was evident as early as his high school years, when he was named valedictorian of his class at 15 years old . He repeated this feat 7 years later at Howard University College of Medicine, graduating at the top of his class. This was followed by a fellowship in surgical oncology at Memorial Sloan Kettering Hospital during which he distinguished himself as one of the stellar fellows. Upon his return as an Assistant Professor of Surgery at Howard University, he quickly rose through the ranks to become Chair of the Department. In addition, as a distinguished surgical oncologist, he rose to become President of the American Cancer Society and the Society of Surgical Oncology, the first African American to hold these positions, prior to his election as President of the American College of Surgeons in 1995. Finally, in 2002, he was named chairman of the President’s Cancer Panel.
Claude H. Organ, Jr. holds the distinction of being the first African American to assume the chairmanship of a department of surgery at a predominantly white medical school, his alma mater, Creighton University . His tremendous work ethic, exceptional commitment to excellence, and unparalleled dedication to mentoring not only earned him the respect of his colleagues and students but also contributed to his success as an academic surgeon. Dr. Organ was the first African American editor of the surgical journal with the largest distribution in the country, Archives of Surgery. In addition, he was a founding member of the Society of Black Academic Surgeons, an organization devoted to promoting mentoring and scholarship among surgical trainees and faculty from an URMM background. In 2003, Dr. Organ became the second African American President of the American College of Surgeons.
L.D. Britt graduated from Harvard Medical School and Harvard School of Public Health on his way to becoming the first African American professor of surgery in the Commonwealth of Virginia and chair of the department of surgery at Eastern Virginia Medical School . During his tenure, he has received numerous accolades nationally and internationally, including the Robert J. Glaser Distinguished Educator Award, the highest teaching award or accolade in medicine given by the Association of American Medical Colleges . He has served as president of numerous prestigious academic surgical societies including the Southern Surgical Society, the American Surgical Association, the American Association for the Surgery of Trauma, the Society of Black Academic Surgeons, and the American College of Surgeons.
There are many other worthy URMM surgical leaders who have had to overcome significant barriers to ultimately play an influential role in American surgery. Time and space do not permit an encyclopedic chronicle of their respective journeys. Suffice it to say, they all shared the same relentless passion for the pursuit of excellence. However, while one can argue that excellence is the essential scaffold for success, it is the quest for significance, or the desire to make the biggest difference possible in the lives of others and in their community, that propelled these trailblazers, legendary pioneers and role models to the heights of American surgery.