Dr Nikki Stamp: Sexism in surgery

On the 5th of September 2018, Dr Nikki Stamp presented a keynote address as part of the JMP’s 40 Years of Medicine Lecture Series. Here’s what transpired.

An agent of change

Meet Dr Nikki Stamp: cardiothoracic surgeon, powerful advocate and inspiring author.

Yes, she is one of only eleven females in a field long unwelcoming to women. Yes, she is currently nominated as a game changer in Cosmopolitan Australia’s Women of the Year awards. No, she doesn’t back down when facing a wall of gender stereotypes.

She’s an “agent of change”, as Harper’s Bazaar put it. She writes for a myriad of publications including the Huffington Post, has appeared as a host of ABC’s hit show, Catalyst, and Podcast One’s Women with Heart. She was named one of 2017’s Women of the Year by Harper’s Bazaar Australia, TimeOut Sydney’s 40 under 40 & Mamamia’s Inspirational Women Your Daughter Can Look Up To.

A fancy plumber

As a curious six-year old, Dr Stamp was an avid reader of books on the human body and she knew the first-aid manuals backwards. Raised in a home where her engineer-father fixed everything, and her mother had meticulous attention to detail, she quickly gravitated toward a career in surgery.

The heart held a great deal of interest for an eight-year old Dr Stamp. “When I grow up”, she wrote in her diary, “I want to be a heart surgeon and finish the work of Dr Victor Chang”. Dr Chang, a Sydney cardiac surgeon, worked on inventing a durable artificial heart to combat donor shortages. Dr Stamp went on to study medicine at the University of Western Australia where she was “always hanging around theatres and loved every minute of it”. Now, nearly three decades after Dr Chang’s death, Dr Stamp proudly calls herself a “fancy plumber”, mending the intricate pipelines of the human body.  

A boys club

But achieving this was no easy feat. Here’s a snapshot of the current climate in surgery. Females make up 51.9% of medical graduates, 30% of applicants for surgical training, 28% of surgical trainees and 11.8% of surgeons. When it comes to females in certain surgical specialties, that number plummets to less than 10%. Furthermore, attrition rates in female surgeons are two times higher than that in males.

And it doesn’t stop there. Females continue to shoulder the bulk of domestic labour which, when matched with a demanding career like surgery, can take a large toll on general health and professional advancement. Not surprisingly, this cause of stress has led to 84% of female surgeons requiring fertility workup and 65% experiencing pregnancy complications.

Defining gender bias

Work-family conflicts are crystallized by vigorous medical training, but gender bias – both conscious and unconscious, from patients and supervisors – is just as much to blame.

Currently, we have two models of gender bias. First-generation gender bias illustrates the deliberate exclusion of females. Moving into the future, research is now geared towards focussing on second-generation gender bias. According to The Harvard Business Review, this comprises the subtle and pervasive cues that bleed into the workplace which worship men yet fail women time and time again. This bias results in few female role models, gendered career paths and double binds that victimise the ‘aggressive’ women but empower the ‘assertive’ man.

All hail the hashtag

It’s imperative that we shed some much-needed light on this thorny list of challenges. Until visibility is achieved, the path to becoming a female surgeon will likely remain a difficult and lonely one.   

Similar to surgery, only 16% of the STEM population is comprised of women. In the summer of 2015, the software company, OneLogin, featured a female engineer in their recruitment advertisement. After receiving backlash that the female could not possibly be an engineer and must be a payed model, the ad went viral. The social media hashtag #ILookLikeAnEngineer was born and became a sentiment to an underlying problem in STEM.

This inspired #ILookLikeASurgeon which was established by Dr Heather Logghe and Dr Sara Scarlet in the USA. They often say that “you can’t be what you can’t see”. Under this tenet, #ILookLikeASurgeon flourished in establishing visible female role models and creating an enormous supportive network. One of many women, Dr Stamp took to social media and proudly proclaimed #ILookLikeASurgeon. This movement culminated in nearly 230,000 posts and 60 academic, peer-reviewed journal articles commenting on its beneficial effect. “It became a positive juggernaut towards equality,” Stamp proudly declares. “It gave us the tools, skills & mentorship that we needed.”

Ensuring female surgeons achieve parity with men will definitely not be an overnight change. There’s no question that such a movement demands the work of consistent, committed and tenacious individuals to break the glass ceiling of the operating suite. It’ll be challenging but Dr Stamp, heels and all, is ready to celebrate womankind.

The Ductus team were fortunate enough to ask Dr Nikki Stamp some questions about her career. Read her responses below.

Can you tell us about your mentors?

I pretty much had exclusively male mentors for the most part of my career. When I started as a medical student, there were very few females around. I was fortunate enough to have good male mentors who taught me and encouraged me into surgery.

As medical students, what can we do to help smash stereotypes?

I think that everyone should be looking around for role models who are not stereotypes and celebrate them. It’s also important to be role models and mentors because sometimes we don’t realise the power we have to be these role models for someone else.

Sometimes male medical students who are aware of these gender issues want to help but don’t know where to start. Do you have any advice for them?

One of the most important things I believe any ally can do is to call out inaccuracies or, at the other end of the spectrum, bad behaviour. The other thing that they can do is ensure they do their level best to elevate other people to ensure everyone can access opportunities.

Do you have any suggestions as to how we can make the most of medical school?

My biggest recommendation is that you go into every rotation with your eyes open, ready to learn and see new and exciting things. No matter where you want to end up in your life, you always have something to gain and something to learn. Plus, you may find a new passion. And, of course, the patients are your best resource who will teach you and enrich your life more than a lot of textbooks ever can.

How do you keep healthy and prevent burnout?

To be perfectly honest, I am still learning all the time. There are times when I look after myself really well and times when I feel quite stressed and burnt out. In general, to look after myself, exercise, a good diet, relaxation time and time with my family and friends keep me at my best. And recognising when things are getting on top of me is key so that I can take a step back and prioritise my own health.

What’s up next for you?

There is lots on my agenda as usual! I’m starting work on my second book which will be out later next year which I am incredibly excited about.

Check out Dr Nikki Stamp’s thought-provoking book ‘Can You Die of a Broken Heart?’ out now!