Women are underrepresented in thoracic surgery, making up less than 4 percent of board-certified surgeons. But today in the U.S., approximately 22 percent of residents in thoracic surgery are women, suggesting that in the future, women will have greater representation in the specialty. At the Brigham, the proportion of female residents in thoracic surgery is even higher — roughly half of all fellows and residents in Thoracic Surgery have been women over the last few years. But a large gap continues to exist and much work will be needed to help close it. Like many specialties where men have historically accounted for the majority of physicians, challenges remain for women looking to enter the field, including compensation gaps, fewer career advancement opportunities and outdated views on family dynamics.
Raphael Bueno, MD, chief of the Division of Thoracic and Cardiac Surgery, wants to ensure that the Brigham is not only a place where female residents can train in thoracic surgery, but also a place where women have opportunities to advance in their careers and have representation at all career levels.
Two new faculty members who have recently joined the team bring with them clinical, research and educational expertise that will help enrich the division and, as women, they help to ensure that the makeup of the division’s faculty more closely match the increasing proportion medical trainees in the field. The two new faculty members — Paula Antonia Ugalde Figueroa, MD, and Desiree Steimer, MD — join three women who are already on the clinical faculty — M. Blair Marshall, MD, Namrata Patil, MD, MPH, and Abby White, DO — and Assunta De Rienzo, PhD, a faculty member in Thoracic research.
“Thoracic Surgery’s approach to ensuring a diverse set of faculty aligns with the Department of Surgery’s philosophical approach to bringing on new faculty members,” said Gerard Doherty, MD, chair of the Department of Surgery. “We conduct open searches for all of our positions and pay deliberate attention to diversity in all its forms in making up an optimal faculty group. This includes both visible and invisible diversity — certainly race, ethnicity and gender, but also training background, sexual orientation and career aspirations.”
“We know that representation matters. For the medical students, residents and fellows we train and for the patients we treat, having female faculty in our division is meaningful on many levels,” said Bueno. “As individuals, Drs. Ugalde and Steimer are tremendously innovative and talented. We’re honored to have them join our team.”
Ugalde is a thoracic surgeon who is dedicated to research and innovation. She describes herself as an international physician — born in Chile and raised in Brazil, she completed a clinical fellowship in Quebec before doing a minimally invasive thoracic surgery fellowship in the U.S.
When Ugalde has been asked about her career path and how she came to be where she is today, she speaks from the heart.
“There is no short answer,” Ugalde says. “I fell in love. Some lucky people fall in love with their spouses and get to stay with them for the rest of their life. That’s how I feel about thoracic surgery.”
Ugalde is the first physician in her family. Her mother is a teacher, and other members of family are engineers. Ugalde stumbled — almost literally — upon her specialty in medical school. While rotating through general surgery and observing procedures, Ugalde went to the wrong operating room. Instead of observing the gallbladder removal she was scheduled to witness, she watched in awe as a thoracic surgeon operated on a patient in the lateral position. She approached the surgeon after and asked, “Can I see more of this?” The conversation changed her life and led her to a mentor whom she would work with for the next 17 years.
When Ugalde began practicing thoracic surgery in Canada, she pursued her interest in clinical innovation, motivated by her desire to cause less pain for her patients. She then became interested in uniportal video-assisted thoracic surgery (uniVATs), a technique that allows a surgeon to perform an operation using a single, small incision.
“One day, I woke up and said, ‘From this day on, I’m doing uniportal surgery,’” said Ugalde. “The first case was not easy. The second wasn’t either. But by my 50th case, I was feeling comfortable.”
Ugalde has since published papers on using uniVATs approaches for lung cancer and has also published on the learning curve for uniVATs procedures.
In addition to performing surgery and conducting research, Ugalde is passionate about mentoring the next generation of physicians.
“I love embracing my role as a female thoracic surgeon and a role model for young women,” said Ugalde. “I love engaging and motivating the younger generation and sharing my experiences.”
When Steimer found thoracic surgery, she found her fit.
“When I talk to people who are thinking about what to specialize in, I tell them to take the time to really get to know the day-to-day life by spending time shadowing someone in the field,” said Steimer. “You don’t want to get a snapshot — you want to see the full picture of what your life will be like. You want to find a specialty that fits you, not make yourself fit into a specialty.”
Steimer’s career in thoracic surgery is spent doing what she loves: performing minimally invasive surgery and interacting with patients and families who are grappling with thoracic conditions, lung cancer, esophageal cancer, thymic malignancies and mesothelioma. Her research focuses on the patient experience, including improving patient education for pre-surgical and postoperative care.
“I enjoy oncology because of the relationships with patients,” said Steimer. “It’s rewarding as a surgeon to offer patients a chance at a cure. These are life-long relationships and the patients, and their families are always so grateful.”
Steimer completed her thoracic training at the Brigham, finishing a cardiothoracic surgical residency and a fellowship in foregut and general thoracic surgery. Staying on as a faculty member allows Steimer to continue learning from the mentors she’s connected with during her training.
“They’ve been instrumental in getting me to this point in my career and teaching me how to perform operations and care for our patients,” said Steimer.
Steimer is looking forward to helping educate others in turn.
“There’s been a concerted effort in both Cardiac and Thoracic Surgery to recruit more women,” said Steimer. “I think having a good mentor is key. My goal, and I think the goal of many of our faculty, is to encourage more women to consider thoracic surgery as a career — to keep an open mind, to explore and to get the full picture of our specialty.”