In 2016 58% of people applying to medicine and dentistry courses were women. However, according to the Royal College of Surgeons of England, only about 12% of consultant surgeons in 2018 were women. Why? A small survey in the BMJ medical journal points to the level of discrimination. As a general surgical trainee, I have been shocked by the experiences reported by some female colleagues. The discrepancy in the number of women applying to medicine and those going on to become consultant surgeons can partly be explained by the higher dropout rate. Could inherent gender discrimination within surgery itself play a part in that?
Female colleagues with children have struggled to be accepted and are seen as less than full-time surgeons, despite working similar hours in hospital to those surgeons with part-time hospital and research commitments. A female surgeon returning from maternity leave didn’t dare tell colleagues that she had a 10-month-old baby at home, fearing that she would be viewed as lacking “commitment to speciality”. Female surgeons are continually asked about their family plans. I was even asked at an international conference if colorectal surgery would be the correct career path if I plan to have children. These aren’t challenges that are unique to surgery – or to women, with more men taking longer paternity leave – yet the stigma seems more entrenched in surgery than other specialities.
Surgery has been thought of as playing to strengths traditionally viewed as “male”, and yet as surgery has advanced we have come to recognise that skills previously considered to be “female characteristics” are essential – such as good communication, empathy and the ability to collaborate effectively. Yet within general surgery female trainees are still encouraged into subspecialities such as breast surgery rather than areas such as colorectal, transplant and trauma surgery which are often considered more demanding.
There are wider issues at play here than simply my quality of life. Having more female surgeons is a good thing. Women are often pleased to have a female surgeon see them in clinic; they feel more comfortable and safer with intimate questions and examinations. One of my patients was thrilled that the whole team performing her appendicectomy (anaesthetist, surgeon, nurses) were female with the exception of one male junior doctor.
I and colleagues have worked for consultants (male and female) who have encouraged women to go into surgery and championed our career progression. More diversity (in every way) is needed; we need different types of surgeons with views, experiences and skills from every type of background. Hopefully those changes are starting to be made, and the next generation of surgeons will see these experiences as stories of the past. It cannot happen soon enough.
• Daniella Donato-Brown is a general surgery registrar