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Evolving challenges of leadership in surgery to improve inclusivity, representation, and well-being

Journal

BRITISH JOURNAL OF SURGERY
Volume -, Issue -, Pages -

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/bjs/znad274

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Leadership in surgery is a complex and demanding process that is crucial to maintaining quality in surgical care. Modern surgical leaders must possess inclusivity, flexibility, emotional competence, team-building skills, and a multidisciplinary approach. They face challenges in the complex healthcare environment and evidence-based strategies are needed to address these challenges, such as increasing representation of marginalized groups in leadership positions, creating a collegial environment, providing reporting pathways for workplace harassment victims, and promoting equitable opportunities and support.
Background Leadership is a complex and demanding process crucial to maintaining quality in surgical systems of care. Once an autocratic practice, modern-day surgical leaders must demonstrate inclusivity, flexibility, emotional competence, team-building, and a multidisciplinary approach. The complex healthcare environment challenges those in leadership positions. The aim of this narrative review was to consolidate the major challenges facing surgeons today and to suggest evidence-based strategies to support surgical leaders.Methods Google Scholar, PubMed, MEDLINE, and Ovid databases were searched to review literature on the challenges faced by surgical leaders. The commonly identified areas that compromise inclusivity and productive leadership practices were consolidated into 10 main subheadings. Further research was conducted using the aforementioned databases to outline the importance of addressing such challenges, and to consolidate evidence-based strategies to resolve them.Results The importance of increasing representation of marginalized groups in leadership positions, including women, ethnic groups, the queer community, and ageing professionals, has been identified by surgical colleges in many countries. Leaders must create a collegial environment with proactive, honest communication and robust reporting pathways for victims of workplace harassment. The retention of diverse, empowering, and educating leaders relies on equitable opportunities, salaries, recognition, and support. Thus, it is important to implement formal training and mentorship, burnout prevention, conflict management, and well-being advocacy.Conclusion There are two aspects to addressing challenges facing surgical leadership; improving advocacy by and for leaders. Systems must be designed to support surgical leaders through formal education and training, meaningful mentorship programmes, and well-being advocacy, thus enabling them to proactively and productively advocate and care for their patients, colleagues, and professional communities. Leadership is a complex and demanding skill that is crucial to maintaining quality in surgical systems of care. There are two aspects to addressing the challenges facing leadership in surgery: improving advocacy by and for leaders. Systems must be designed to support surgical leaders through formal education and training, meaningful mentorship programmes, and well-being advocacy, enabling them to proactively and productively advocate and care for their patients, colleagues, and professional communities.

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