Honoring the tradition

To reach the office of Nita Ahuja, MD, MBA, Yale’s newest chair of surgery, one passes portraits of her 14 predecessors. Under the heading “Surgery Department Leaders,” they presided from 1813 (when Nathan Smith, MD, became surgery’s first chair) until 2016, when Ahuja’s predecessor, Robert Udelsman, MD, MBA, left the post. It’s a quick overview of Yale School of Medicine’s history, and in terms of gender distribution, the history of medicine as well. The wall will have to be updated.

Ahuja, the first woman to lead the department, is also the William H. Carmalt Professor of Surgery, and surgeon-in-chief at Yale New Haven Hospital. She is one of 19 women who chair surgery departments in the United States, according to the Association of Women Surgeons. Medicine and surgery in particular have traditionally been male-dominated fields. But that is changing.

“It’s catching, isn’t it?” Ahuja said of the slew of female surgeons—five—who joined the surgery department faculty after her appointment in February. “If there’s one woman, she’s an outlier, right?” she said. But “once you make it past a tipping point, it becomes the norm.”

As chair, Ahuja aims to focus on sustaining and improving Yale’s top-notch clinical care, expanding laboratory research, and training tomorrow’s surgeons. She also wants to make the surgery department staff more reflective of the population it treats.

Ahuja came to Yale from Johns Hopkins University, where she completed her residency, joined the faculty, taught, and conducted research for nearly 25 years.

“She was a superstar—great clinician and teacher and had fabulous research experience and ideas,” said Julie Freischlag, MD, now CEO of Wake Forest Baptist Medical Center in North Carolina. Freischlag hired Ahuja as Hopkins faculty in 2003. “I always knew she would be a chair.”

At Hopkins, Ahuja gained renown for research on cancer epigenetics, or the study of certain types of changes to the DNA of cancer cells. While genetic changes alter DNA sequences, epigenetic changes—such as the addition of methyl groups to the proteins around which DNA wraps—do not. Ahuja also started programs to treat two types of tumors requiring complex surgeries: sarcomas and peritoneal cancers. “I’ve always worked to say, ‘What are we not offering? Let’s figure it out and let’s make sure we are offering it so patients get the best [care that can be provided],’ ” she said.

At Yale, Ahuja will continue building programs to give patients optimal care. For example, a new cardiac institute is on the horizon, she said.

Another of Ahuja’s goals is to shore up the “leaky pipeline” in which women fail to attain higher medical leadership positions. She also hopes to make the department more inclusive. “The idea is to welcome all people,” Ahuja said. “You want to find the best and select them and welcome them to your department, say, ‘If you think you want to come in here, we want to engage you,’ and that means it shouldn’t be defined by gender or by your race or other things. We want the best.”

Talent, hard work, and support from mentors and family helped propel Ahuja to the top.

Born in India, she immigrated to the United States with her parents and sister at age 8. “It was mostly about you two girls getting a good education and doing what you want,” Ahuja’s father told her. Ahuja wanted to be a doctor.

Heading into medical school at Duke University in 1989, she had not yet selected a specialty, but after a year of breast cancer research in the lab of James Iglehart, MD, now at Harvard, she decided to become a cancer surgeon. This wasn’t an obvious choice for a woman, she recalled. “There were no women surgeons at Duke at that time. The entire department, I think, had one woman who was in the laboratory doing research.”

Ahuja’s first mentor in surgery was an Ob/Gyn, Charles Hammond, MD, and he made her feel that surgery was a career option. “He made it open,” Ahuja said. “He welcomed me.” Ahuja initially thought she would become a gynecologic oncologist but ultimately decided on surgical oncology and began a joint residency and fellowship program in surgical oncology at Hopkins in 1993.

Midway through the program, in 1999, Ahuja was confronted with a dilemma familiar to female doctors: the overlap between medical training and childbearing years. She was pregnant, and as a resident, had no real maternity leave. She and her husband could not afford round-the-clock childcare, so Ahuja’s mother moved in to help take care of the baby. “My parents are a big part of how I arrived in this position,” Ahuja said. “I had my baby and then went back to work.”

In 2003, Freischlag became chair of surgery at Hopkins. “This was an important move not only for Johns Hopkins but I think for the country as a whole,” Ahuja said. Not only was Freischlag the first female chair of surgery at Hopkins but she was also one of the first in the country and among the first at a big institution. That same year, Freischlag hired Ahuja and since then “has been a role model and really a big supporter,” Ahuja said.

Just as her mentors at Duke and Hopkins fostered her rise to leadership, Ahuja wants to support future leaders at Yale. “That’s what someone did for me and that’s what motivates me today to pay it forward to the next generation,” she said.

Her interest is not limited to advancing women in surgery. “It’s not like women bring anything magical, you’re just bringing different perspectives,” she said. What’s paramount, she said, is diversity, which helps improve an organization’s ability to innovate and adapt during times of rapid change as in medicine today. “As there are different types of leaders we now allow the people behind them to see that it’s OK for them to be different and bring different viewpoints,” Ahuja said. She brings the perspective of an Indian-American woman. “Hopefully,” she said, “that means more diverse leaders can thrive at Yale School of Medicine.”