It all began with the the cover of the April 3 edition of The New Yorker magazine – a illustration of four women surgeons in surgical masks and gowns looking down at a patient in an operating theatre. French artist Malika Favre who drew the “operating theatre” for the magazine’s health, medicine and body issue was trying to capture a patient’s feeling of being watched as they lose consciousness under anesthesia. Favre was drawing form her own experience of being operated on when she was a child.

When endocrine surgeon at the University of Wisconsin Dr Susan Pitt saw the image, she immediately wondered what it would look like to recreate the image. “The instant I saw it I thought about how cool it would be to replicate in real life,” Pitt told BuzzFeed. While attending a meeting of endocrine surgeons, Pitt gathered three other women surgeons and took a photo. She tweeted it out using the the hashtag #ILookLikeASurgeon and challenging other women surgeons to do the same.

Women surgeons across the United States and in other parts of the world – Mexico, Brazil, Turkey and Saudi Arabia – have quickly stepped up to take photos of their own recreations of the magazine cover. The challenge has now been trending on Twitter as the #NYerORCoverChallenge.

While the New Yorker cover challenge has certainly thrown up some great photos, the women taking part are hoping it will help challenge assumptions women in medicine. Surgery is a male-dominated profession around the world. Only 19% of surgeons in the US are women, according to statistics from the American Medical Association.

The Association of Women Surgeons of India contends that only 700 of 25,000 Indian surgeons are women. In March 2016, the Times of India reported that women surgeons were a “vanishing tribe” in Hyderabad. Records from corporate hospitals across the city showed that only 10% of their surgeons were women and almost all of these were restricted to gynaecology and obstetrics departments. There were few women in ophthalmology or general surgery. There were even fewer in super specialities within surgery like cardio-thoracic surgery, oncology, urology, paediatrics, plastic surgery, neurology and gastroenterology.

This is largely because surgery has mostly been an all-boys club, points out Dr Sristi Sharma, a surgery policy researcher and founder of the Association of Women Surgeons of India. “It is difficult for a woman to break in and be a part of that club not only because of their own fears but also because there is an inherent bias against women from the existing male surgeons as well as general public,” said Sharma. “Rampant sexist comments including ‘how will you manage?’, ‘You will destroy your family’, ‘Who will replace you when you are pregnant? We will be short staffed.’ Ask any woman surgeon-at some point of her life she has heard one of these cutting remarks.”

Sharma recounted a story from her time at NRS Hospital in Kolkata, where the head of surgery was a a very capable and experienced woman. However, when she did her rounds in the wards with other surgeons, patients would always direct their questions to the male surgeons.

With so few existing women surgeons, the newer generation of medical students have few women mentors and role models.

The social media campaign #ILookLikeASurgeon started much before The New Yorker’s April cover this year. It took off on Twitter in August 2015, with women surgeon using the hashtag to draw attention to problems of gender, racial and ethnic diversity in the profession of surgery. The tweet and the hashtag have brought together women in surgical and other medical organisations and is fast becoming a movement with goals to address problems of diversity in surgery, the wage gap, leadership barriers, work-life integration, burnout, surgical and workplace culture, and surgical stereotypes.

Trauma surgeon Jamie Jones Coleman writes in The Huffington Post that she took part in the #NYerORCoverChallenge to counter the predominant assumption of what a surgeon should look like. “Let’s say every surgeon you have met in your life is male and every nurse you have met is female. Therefore, when a male walks into the examination room you mistake him for the surgeon when he is, in fact, your nurse. This doesn’t make you a bad person, again, a good portion of this is unconsciously done... his is how we unconsciously send messages to our children and young people that women shouldn’t be surgeons because we don’t expect them to be, and that a person’s appearance, race, or gender should dictate who they are and what they become.”

Indian women surgeons do not want to be left behind in this movement. The Association of Women Surgeons in India has asked their members to join in the highly visible New Yorker Cover Challenge on social media. “Currently, the state of affairs is such that women surgeons in our country do not even realize the biases they face,” said Sharma. “Sexist comments are normalised, being passed over for leadership positions are accepted, even patient attitudes are tolerated. However, things will not change unless the 700 or so women surgeons stand up and say ‘Look at us-we do exist. And we are no different from you.’”

Here is their first #NYerORCoverChallenge photo.

Photo: Association of Women Surgeons of India.