America’s surgeons are not woke enough, according to the American College of Surgeons (ACS). Such is the message of the leadership to fellows of the ACS. {snip} To underscore its ongoing commitment to anti-racism and DEI, the ACS just launched its DEI Toolkit and continues to promote this ideology as though its life depended on it.
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And, yet, the American College of Surgeons has grabbed onto the ideology of structural racism and just won’t let go. After embracing anti-racism and DEI in 2020 and promoting the ideologies at the 2023 annual Clinical Congress in October, the leadership of the ACS is seeking to further embed anti-racism and DEI in the college and into surgical practices. {snip}
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The list of topics covered in the organization’s DEI Toolkit includes every element that supports the fiction of systemic racism: intersectionality, microaggressions, implicit bias, allyship, active bystander, white privilege, and more. Perhaps the most egregious aspect of the tool kit is its relentless persistence of referring to surgeons and patients by their identity groups. If a surgeon does not take into account a patient’s identity group in caring for them, the tool kit asserts that surgical care and outcomes will be compromised. Like all group identity–based practices, the tool kit treats each group, e.g. blacks, as though they were homogenous. All blacks, for example, are victims of oppression and systemic racism, according to this thinking. The traditional tenets of Hippocratic medicine, which focus on the individual in front of the physician, have been, for all intents and purposes, abandoned. Any disparity in outcomes of care of minorities is proof of racial discrimination.
One of the most troubling aspects of anti-racism and DEI is the effect on surgical education. Surgery is a very difficult, demanding profession that takes years to master. There is a finite amount of time in residency training to mold a competent surgeon from a fumble-fingered intern. To assume that we can continue to turn out excellent surgeons and simultaneously burden surgical education with the degree of time-consuming indoctrination in anti-racism and DEI demanded by the ACS tool kit is, at best, foolish and futile, and, at worst, dangerous to our patients. I have spoken to many of my surgical peers, and we agree that we are already seeing an erosion of quality in surgery, with many programs turning out surgeons who are not ready to practice independently. I have spoken to surgical residents who report a sense that they are not getting the necessary hands-on clinical and surgical experience to feel confident, while being simultaneously tasked with assimilating and regurgitating anti-racist and DEI ideology.
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