A Valuable Lesson in Inclusiveness

How future surgeons—and their mentors—learned that equity in health care is about more than what happens in the OR.

surgeon with mask and camera.

A University at Buffalo program meant to foster diversity in the surgical field turned out to provide even broader lessons about inclusiveness—not just for med students, but for their mentors as well.  

Fewer than 7% of academic surgeons in the U.S. come from underrepresented groups. Driven by that fact, the Department of Surgery launched the Summer Diversity Research Mentorship Program in 2020, hoping to encourage underrepresented first-year students at the Jacobs School of Medicine and­­ Biomedical Sciences to pursue surgery.

The three students selected for the inaugural program gained experience in the operating room under the mentorship of attending surgeons. In addition, they had an opportunity to conduct research on health disparities in the majority-Black neighborhood, known as the Fruit Belt, adjacent to the UB medical school.

A problematic approach

The original research plan was focused on finding out how residents viewed the importance of screening for colorectal cancer and breast cancer.

But early in the process, according to Michael Lamb, research associate professor of surgery and mentorship program director, Fruit Belt residents made it clear they weren’t thrilled with the approach.

Wrote Lamb and the students in a paper that is currently out for review: “In retrospect, it’s easy to see how inadvisable it would have been to venture forth into the Fruit Belt greeting residents with a ‘Good morning, I’d like to ask about your colorectal health.’”

Lamb referred to that alienating approach as “extractive research”—good for the researcher’s CV, but oblivious to the community’s needs.

A ‘space of trust’

As the summer progressed and the students gained critical experience in surgery, they also reimagined the research component from a new perspective, seeking to more respectfully engage with the community they were hoping to serve.

Lamb and the students spent their days meeting with as many residents and stakeholders as they could, hosting lunch and dinner meetings, and working on community-identified priorities—sometimes simply stacking tables or emptying serving trays after events. By the end of the summer, they had laid the foundation for a “co-created, non-hierarchical space of trust”: a place where community members could share their perspectives and goals with medical school faculty and students, and also explore how the university might best assist in their achievement.

Lamb has been involved in community-based participatory projects since graduate school and, for him, the reasons are simple. “In the old model, researchers dictated the terms of engagement from their own positions. All too often, communities are consulted late in the process—and asked to play a confirmatory role rather than an active one. We want to work with community members from the beginning—to develop a path together.”

Gaining confidence and a voice

As for the students, they gained far more knowledge than they could have ever expected.

“On a personal level, as a Black woman interested in a highly competitive field with little to no prior knowledge or social capital, it was incredibly beneficial and meaningful to me to be able to share my interests, express my curiosities, and gain confidence in my voice and skills while navigating various academic, clinical, research-based, community-driven and residential spaces throughout the summer,” said Abena Ansah-Yeboah.

Added Nigel Marine: “Thanks to hands-on training from an excellent surgical resident, we were able to learn the basics: how to scrub; how to suture and tie surgical knots; how to operate laparoscopic tools in a controlled setting. I learned so much and I attribute it all to this fellowship and to those individuals that made it possible to enjoy such a fulfilling summer.”

And in the words of Mario Carillo: “It was amazing to be able to spend my summer learning firsthand from attending and resident surgeons. However, some of the most meaningful days were those spent listening and learning from members of the Fruit Belt, understanding the history of their community and the challenges they have faced.”