Why surgery remains an old boys’ club

By Michael Woodhead

14 Jan 2019

Sexism is rife in surgical specialties, with more than half of women reporting having faced or witnessed discrimination in the workplace, according to an online poll of female surgeons.

Orthopaedics was seen as the most sexist of all the surgical specialties with 53% of the responses from 81 female surgeons nominating it as discriminatory, followed by cardiothoracic (13%) and general surgery (12%).

The survey was conducted through the Association of Surgeons of Great Britain and Ireland (ASGBI) women in surgery Facebook page in October 2017.

Most women (88%) felt that surgery remained male-dominated, 59% of women said they had had experienced discrimination, and 22% perceived a ‘glass ceiling’ in surgical training with an overriding feeling that the working culture is geared to men.

“When you want to have a family you are at senior level for jobs. It is harder to stay focused on career and your CV. This affects the quality of your CV at interview for consultancy,” said one respondent.

The rigidity in surgical career structures created a bias against women, they said.

“There needs to be a real understanding that having a small child really hinders the ability to do things like extra work that needs to be completed out of hours. If there was a way to come back into training but have a pause on in counting towards your time up then there would be less financial and timescale stress,” said one.

Motherhood and childcare commitments are the greatest obstacles for women wanting a career in surgery, along with a lack of formal mentorship, gender stereotypes and poor work–life balance.

Female surgeons said there was a need to change the negative perceptions of less than full time work, reduce the perceived stigma associated with women who take career breaks, and increase understanding of the perceived impact of family on day-to-day work activities.

They also noted direct and indirect discrimination, with patients and colleagues often equally guilty of assuming women couldn’t be surgeons:

“I find the surprise and confusion and refusal to believe I’m an orthopod for example, ‘you’re too nice to be an orthopod’ and ‘that’s not something to be proud of’ very frustrating,” said one.

‘I have done the WHO [surgical safety]  checklist and then had the comment ‘we need to wait for the surgeon’ despite having introduced myself as the surgeon’

And with around 6 in 10 women reporting experience of discrimination, the responses suggested “an ancient culture pervading our society since the 1800s, at the time of the first female surgeon in the UK, Elizabeth Garrett,” the researchers concluded in BMJ Open.

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