Biases in surgical education may, in part, be skin-deep.
That summarizes recent research by five second-year students in Des Moines University’s doctor of osteopathic medicine program. The students were invited to present their findings in a paper, titled “Visual misrepresentation: the lack of racial and gender equity in surgical textbooks,” during the Surgical Education Week conference of the Association of Program Directors in Surgery.
The students’ work earned the conference’s Outstanding Medical Student Paper Award. That’s especially impressive given that most of the presenters and attendees at the annual event are residency program directors and medical residents, not students.
“We were very well received by everyone. Several D.O.s told us they were proud and excited we were there,” says Connor Frawley, D.O.’25, one of the paper’s authors. Other authors were students Leah Anderton, D.O.’25; Madeline Johnson, D.O.’25, M.S.A.’24; Jesse Chan, D.O.’25; and Chelsea Garcia, D.O.’25; Paul Schenarts, M.D., FACS, MAMSE, associate dean for clinical affairs and professor of surgery in DMU’s College of Osteopathic Medicine; and Brett Waibel, M.D., FACS, associate professor of surgery at the University of Nebraska.
Schenarts gave the students the idea for their research. They analyzed the skin tones and genders of patients and medical staff in the “big three” U.S. surgery textbooks and performed literature reviews on the topic.
“There were mostly white skin tones and more men shown,” says Anderton, who gave the presentation at the conference. “Many studies have shown different surgical outcomes among women and marginalized populations than white men, and bias in textbooks may contribute to that.”
It also may subtly discourage women and those underrepresented in health care from pursuing a surgical specialty.
“Students might feel they don’t belong in the profession if they don’t see people who look like them,” Frawley says.
The students’ research hasn’t been published yet, but already it’s caught the attention of the authors of one of the textbooks they analyzed. “The textbook is being updated, so they might use our research,” says Johnson, who is pursuing her master of science in anatomy degree at DMU in addition to a D.O. degree.
In addition to gaining research experience, the students enjoyed rubbing elbows with others at the conference.
“It was great for networking. Dr. Schenarts introduced us to a lot of people,” Johnson says. “The conference gave us a sneak peek of something we can do in the future, and it showed us that what we do as medical students is important.”
The conference’s location in San Diego was another benefit. “So many good tacos,” Frawley says.
