Voices for change: Celebrating diversity within the AO

My AO Access journey: Marinis Pirpiris
True collaboration—a genuine willingness to listen to often disparate perspectives and experiences and work toward common goals—is essential to the AO’s work to identify and eliminate barriers to entry and advancement within the organization, according to Australian orthopedic surgeon Marinis Pirpiris, who leads the AO Access Mentorship Task Force.

Pirpiris, an associate professor and chair of orthopedics at Cabrini Medical Hospitals in Melbourne, Australia, said his professional journey has been shaped in large part by his cultural background. Pirpiris is a regional AO Trustee, chair of community development for AO Trauma Asia Pacific, an educator with the AO Program for Education and Excellence in Research (AO PEER) and the Faculty Education Program (FEP), and past chairperson of AO Trauma Australia. He has an appreciation for collaboration, and the inspiration and support of mentors and sponsors along the way has been an integral part of his career.

“I grew up in Melbourne as one of three children in an immigrant family. My parents emigrated from the mountainous Arcadia area in the northern Peloponnese region of Greece after World War II, seeking a better life for their children,” he explained. “We grew up in a very carefree, liberal, relaxed lifestyle where we celebrated our culture: our language, our history, and our traditions. We also learned a lot from the local Australian culture at the time.”

It was important to Pirpiris and his siblings to make their parents proud.

“Our parents reminded us that it was important for us to work hard and do well so that we could have better lives for ourselves,” Pirpiris said, noting that he attended school with children from both local Australian and immigrant families from Greece, Italy, France, and even Germany. “It was a very mixed population and a very colorful childhood.”


The influence of unconscious bias

As idyllic as it may sound, that childhood was not without challenges.

“As a child of an immigrant family growing up in a city with a number of other immigrant children, I very quickly realized that there were two strong perceptions of what the community was like: There was a group that decided it was an antagonistic relationship with the environment—that the environment wasn’t as receptive of who they were, their skillsets, ethnicity, background, and personal beliefs,” Pirpiris recalled. “And there was another group—like myself—that was all about celebrating our differences and really committing to the change process and getting out there and showing them what we had to offer, rather than thinking about the things we were doing differently.”

Some of the challenges Pirpiris navigated during his youth were influenced by what he today recognizes as unconscious bias: a prejudice or stereotype an individual may hold—and be unaware of—about a particular individual or group. 

“For example, in primary school, we Greek children were never encouraged to speak Greek among ourselves. In fact, at the time, Australia had a ‘White Australia’ policy of assimilation,” he explained. “And there were times when people would make those flippant little comments like, ‘Oh, it’s just one of those children from an immigrant family,’ or ‘Just another Greek child who’d really like to go a certain way but very few of you actually achieve those goals.’”

“It is important to realize that different people from different religious or social backgrounds may express themselves in slightly different ways.”

Marinis Pirpiris


‘Tomorrow is a new opportunity’

When he shared such disparaging comments with his parents, they were resolute.

“We would decide, ‘Tomorrow is a new opportunity and we just continue pushing and doing our best,’ because we were the pathfinders at the time—not just myself but also the generation of immigrant children before me and the generation before that,” said Pirpiris.


Medicine: an obvious choice

With his curiosity about how things work, his natural understanding of science, a career in medicine seemed like an obvious choice for Pirpiris. And even that was influenced by his cultural background—and by his desire to find a cure for cerebral palsy.

“I think this influenced my attraction to medicine; I thought maybe I could find a cure for cerebral palsy,” he said, noting that he did his PhD work in a hospital that was investigating ways to make pediatric cerebral palsy patients’ lives better in terms of surgery and surgical outcomes.

Ultimately, Pirpiris decided to focus on orthopedics and trauma due to the field’s constant evolution. This, in turn, led him to the AO, when he had the opportunity to attend the AO Trauma Course—Principles of Fracture Management event at the AO Davos Courses 1992 in Switzerland. Subsequently, having completed advanced and masters courses in Davos, AO Trauma faculty member and fellow Australian Ian Harris asked him to begin teaching AO courses in Australia. Harris was one of several mentors and sponsors who have encouraged Pirpiris over the course of his education and early career.

“I could see their genuine caring in terms of where my life was going, and I was very impressed because I was a child of an immigrant family,” he said. “[These mentors] had grown up in an Australian system that was predominantly an Anglo-Celtic culture, and they helped me along, in terms of getting into the orthopedic training program and then, later, traveling overseas to further my training in the United Kingdom and the United States.”

“Collaboration builds many more bridges than being antagonistic with your environment. Be collaborative, stay strong in your ideals and steadfast in your resolve.”

Marinis Pirpiris


Looking to the future

Today, Pirpiris challenges people to appreciate that cultural perspectives sometimes express themselves in subtle—yet different—ways.

“For example, when we are sitting in a meeting, it is important to realize that different people from different religious or social backgrounds may express themselves in slightly different ways. As an Australian of Greek descent, I may express myself differently to an Australian of Anglo-Celtic background,” he said. “It is about harnessing the idea and understanding the individual that allows us to move forward more effectively. It is the energy of the presentation of the idea—the hand gestures, the facial expressions—and this should not necessarily be off-putting. It should be: ‘Hey, this person is really enthusiastic and trusting me to listen to this idea.’”

Pirpiris is confident that the AO is moving in the right direction in terms of diversity, inclusion, and mentorship.

“When we look at the orthopedic community and actual representation—gender, cultures, and ethnicities—gender is one area that stands out more than anything else. We’ve looked at the research and there are more women applying to [orthopedics programs] but we’re not at gender parity,” he said, explaining that while women represent about 50 percent of people at universities, they represent only 30 percent of those entering surgical programs and only 15 percent of those entering orthopedics.

“So, we have a lot more work to do in terms of having positive role models, positive stories, flexible work arrangements, the work-life balance during orthopedics training, etc,” Pirpiris said, adding that other underrepresented groups and the barriers they face must also be included. “Whether it’s sexual orientation, gender identity, culture, race, ethnicity, disabilities, or personal belief, we need to find ways for underrepresented groups to flourish as they move through the AO.”

Genuine collaboration underpins forward momentum, he said. 

“One of the things I’ve found in my life is that collaboration builds many more bridges than being antagonistic with your environment. Be collaborative, stay strong in your ideals and steadfast in your resolve,” Pirpiris said he would advise science, technology, engineering, mathematics, and medicine (STEMM) candidates. “If you think something really needs to change, you need to—in a very articulate and sophisticated way—create a group, find collaborators, advocate for that change. Then, through a mentor, sponsor, or steering committee, described how you might make those changes occur and utilize your supporters and advocates to encourage discussion among the leadership groups, and affect change. The key is taking advantage of your background, your mentors and your sponsors moving forward to help you build a career that helps you meet your goals.”

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