Fellowship in the College was an honor and not all surgeons sought or attained it. I did, and attained Fellow status in 1993.
In the 28 years since, I have admittedly not been very active with the ACS, such as attending meetings, and such. With discretionary time limited, I always devoted more time to my national and state specialty societies. Even so, I paid my dues faithfully and supported the College when asked, such as writing legislators on issues relevant to surgery. I displayed my framed certificate and Fellowship pledge proudly in my office and had ‘FACS’ after my MD, like all other Fellows.
Recently, the ACS has taken a turn I find disturbing. I first noted this in a lecture given before the College by Dr. Joan Reede, a pediatrician and Dean of Diversity and Community Partnership at Harvard Medical School in 2019. Dr. Reede’s lecture was titiled ‘Diversity, Excellence, and Inclusion in medicine and, more specifically, surgery, even though she is not a surgeon. The text of the lecture made no mention of excellence. She checked off multiple progressive boxes in her lecture- diversity, inclusion, equity, biases of various sorts, microaggressions- as problems in surgery training and in the ACS. What was notably absent was balancing this with traditional surgical values of excellence, hard work, and meritocracy.
Subsequent lectures and articles coming out of the College, from the President on down, have been replete with progressive ideology and focused on issues of diversity, inclusiveness, equity, and social justice. All are laudable goals, but they have become poisoned with ideological meaning and taken primacy over other considerations, such as excellence, professionalism, competence, and compassion, which should be the overarching priorities in something like surgical practice.
Success in obtaining a residency position in any surgical specialty depends more on one’s performance in medical school, recommendations from one’s professors, and demonstrated dedication, such as taking a year to do research (as my daughter did to obtain an excellent residency in dermatology), than on gender, race, ethnicity, or some other identity. With medical school classes now 50% or more female and wide diversity in racial and ethnic composition, it is disingenuous to claim that our residencies and our College lack diversity or inclusiveness. Moreover, anyone who meets the requirements of Fellowship is welcome.
In the February Bulletin of the College, an article on diversity and inclusion in the surgical workforce included this paragraph: Although recruiting from and promoting inclusion of different demographic pools seems simple, it can be challenging because of what is known as the Dunning-Kruger Effect. This cognitive bias is a type of anosognosia that leads an individual to make an illusory, superior self-assessment. For example, a white, heteronormative male who lacks an appreciation or awareness of the importance of diversity fails to acknowledge this deficit, then incorrectly claims to be culturally dexterous. Such a cognitive bias ultimately risks perpetuation of the lack of diversity in the surgical workforce.”
The last straw came when I reviewed the recommendations of the College’s task force on racism in surgery, among which was adding anti-racism to the College’s existing values. My College is now considering embracing Critical Race Theory (CRT), which posits all of human history as little more than the never-ending oppression of non-whites by whites and views literally everything through a racist lens. There is wide disagreement regarding this even among those of color and many find CRT abhorrent. According to CRT, it is not enough to declare oneself not a racist; one has to specifically support anti-racism, a construct of CRT. Why? Because whites are so endemically racist they no longer see this in themselves. Whites cannot even enter in the discussion of racism because they lack self-awareness of their own racism and must be re-educated to recognize their unconscious racist tendencies. The College has proposed such re-education programs already.
In addition to its new anti-racism stance, the College has embraced the concept of microaggressions, which can be literally anything- a comment, a word, a facial expression, even an almost imperceptible twitch or gesture- that makes someone of a different race, ethnicity, gender, or ideological position uncomfortable. Nuance, context, and perspective are irrelevant. There are no accidents or unintentional actions. Microaggressions are to be interpreted in the worst possible way. I was incredulous when I read that the College was planning ‘safe spaces’ for young surgeons.
I simply cannot support the progressive direction of the College. I have written the President, J. Wayne Meredith, laying out my reasons for dropping my Fellowship status, but have yet to receive any acknowledgement or response. I expected this. I am just one voice and have no clue how many others feel the same. It breaks my heart as I never imagined such a day would ever come.
R. Bosshardt, MD, (no longer) FACS