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A necessary paradigm shift: recognizing the surgeon-advocate in academic surgery
Adom Bondzi-Simpson1, Betel Yibrehu1, Amanpreet K Brar2
1From the Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Ont. (Bondzi-Simpson, Yibrehu, A.K. Brar, Yee, Fellows, Ahmed, S. Brar); the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ont. (Bondzi-Simpson, Ayoo, Yee, Valiquette, Nguyen, Malhotra); the UpSurge mentorship program (Bondzi-Simpson, Yibrehu, A.K. Brar, Bakhache, Ayoo, Yee, Valiquette, Fellows, Nguyen, Malhotra, S. Brar); the Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ont. (Bakhache); the Department of Surgery, Division of Vascular Surgery, University of Toronto, Toronto, Ont. (Ayoo); the Department of Surgery, Division of Plastic, Reconstructive and Aesthetic Surgery, University of Toronto, Toronto, Ont. (Valiquette); the Department of Surgery, Division of Urology, University of Toronto, Toronto, Ont. (Nguyen); the Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ont. (Malhotra); the Department of Surgery, Division of General Surgery, St. Michael's Hospital, Toronto, Ont. (Ahmed); the Department of Surgical Oncology, Mount Sinai Hospital/Princess Margaret Cancer Centre, Toronto, Ont. (S. Brar).
Academic medicine must value advocacy to advance health equity. Redesigning medical education and faculty roles, including the surgeon-advocate, is crucial for supporting equity-focused work.
Area of Science:
- Health Services Research
- Medical Education
- Public Health Policy
Background:
- Health equity and social determinants of health are global priorities.
- Academic medicine currently undervalues advocacy, hindering support for equity-focused initiatives.
- Existing structures in academic medicine do not adequately recognize advocacy as a core pillar.
Purpose of the Study:
- To argue for the integration of advocacy as an academic pillar in academic medicine.
- To propose a redesign of academic medicine structures to support equity-based advocacy.
- To introduce the concept of the surgeon-advocate to facilitate systemic change.
Main Methods:
- Conceptual analysis and critical review of academic medicine structures.
- Examination of current criteria for teaching, hiring, and promotion.
- Proposal for integrating advocacy into medical education and faculty roles.
Main Results:
- Advocacy is undervalued in academic medicine, impacting equity efforts.
- A paradigm shift is needed to formally recognize and support advocacy.
- The surgeon-advocate role is proposed as vital for advancing equity.
Conclusions:
- Academic medicine requires structural revision to prioritize health equity.
- Integrating advocacy into medical education and faculty pathways is essential.
- Embracing advocacy formally will advance health equity goals.
