Greta McLachlan: Women in surgery—it’s improving, but slowly

No carpenter, smith, weaver, or women shall practise surgery,” proclaimed Henry VIII some time before he granted the charter for the company of barber surgeons in 1540. Fortunately surgery has come some way since then. We have anaesthesia, laparoscopic surgeries, and antibiotics. Even women are allowed to be surgeons.

But while technology leads to advances in surgery, medieval views about female surgeons still exist. Most recently shown by a survey of female surgeons. [2] Out of 81 respondents, 59% “reported or witnessed discrimination against females in the workplace” But 81 participants is a small number. Those who took the survey, are likely to have a self selection bias, probably they had issues they wished to air. Which is a perfectly valid argument. Except that by accepting this argument, you are accepting the reality that 47 female surgeons have, at least one time, been discriminated against, because of their genitalia.

At this point I could list all the anecdotal examples that I have come across in my 15 years of medical experience.

But I won’t. Because you’ve heard them before.

The surgeon who’s called a nurse. The surgeon whose pregnant abdomen is touched, while being told “I find pregnant women sexy.” The constant questioning of whether you want a family, as this might alter your surgical specialty choice. You have seen these and witnessed these. This is not just 47 surgeons getting on their soapbox and shouting loudly. This is a whole generation of surgeons saying—think before you speak. This is female surgeons asking to be treated the same as their male counterparts, to be given the same opportunities, while yes, occasionally having to go and create life for a few months. Because those with XY chromosomes can’t.

Now all of that being said, things are better than they used to be. James Barry (1795 – 1865), who performed the first successful caesarean section, was in fact a woman—Miranda StewartWe no longer have to pretend to be men to practise medicine or surgery. In fact we can apply to any specialty we like and we have the vote. My mother was once told that the reason she couldn’t have a job was simple. She was a woman and her brain was wasted on her. Things are better than that. But there is still room for improvement.

In 2000, there were only 5% female consultants in surgery. [3] Since 2013 this number has remained static at 12%. [4,5] So yes, it’s improving, but slowly. We have had our first female president of the Royal College of Surgeons, Dame Clare Marx, 30% of higher surgical trainees are female, and 20% of SAS doctors are women. [5]

We have more female surgical role models than we have had before. This has a positive effect, as it gives juniors the opportunity to see themselves represented at the higher levels and offers diversity of thought. It allows patients to be treated by someone of the same sex, which can be invaluable for them. Female surgeons have even been shown to have better outcomes than their male counterparts. [6]

But we still need to keep working at the problem. We are better than we were, but not as good as we will be tomorrow. We all need to—men and women—call out discrimination when we see it, or have it done to us. We know that the majority of staff working in the NHS are not sexist. In fact most will be saddened to know this happens still.

In 2019.

In the UK.

For some, it will not even have occurred to them that their words are hurtful or demeaning.

So to get the ball rolling on making a change. To help some of the confused staff members and public out there, to make sure their language is not gender biased or discriminatory, I have found a little hack for you. [7]

Before you make your comment, or start that conversation with your female counterpart (this is for both men and women), consider this. Would you make that comment to Dwayne The Rock Johnson? If yes, you are okay to have this conversation with your female surgeon too. If not. Think again, as you will probably be causing offense.

Greta McLachlan is a general surgical trainee currently working at The BMJ as the editorial registrar. Twitter @geemclachlan

Competing interests: I have read and understood BMJ policy on declaration of interests and declare the following interests: I am on the National Medical Director’s Clinical Fellow scheme, which is mentioned in this article.