How Low Is the Glass Ceiling for Women Surgeons?

Peter Russell

January 08, 2019

More than half of female surgeons in the UK have faced or witnessed discrimination at work, according to new research.

Results from an online survey published in the journal BMJ Open found that most women felt that surgery remained a male-dominated field.

Orthopaedics was identified as the most sexist of the surgical specialties.

Respondents said that challenging sexist language and making surgery a more family-friendly profession would help tackle discrimination.

Social Media Questionnaire

Female surgeons were invited to participate in the confidential poll through a survey distributed via the Association of Surgeons of Great Britain and Ireland (ASGBI) women in surgery Facebook page, and shared on Twitter for 2 weeks in October 2017.

Nine out of 10 members of the social media group are women, with 69% of members aged between 25 and 44. Most surgeons were from the UK (70%) but it also included surgeons from India, Pakistan, the US, Europe, and Africa.

A total of 81 female participants responded, of whom:

  • 88% perceived surgery as male-dominated

  • 59% said they had experienced discrimination

  • 21% perceived a 'glass ceiling' in the profession

Orthopaedics was reported as the most sexist surgical specialty by 53% of respondents, followed by cardiothoracic surgery (16%), and general surgery (15%).

Flexible Working and Family Life

The hidden barriers for women, reported by 34%, were that the profession was not conducive to motherhood and family life, with 16% citing childcare issues.

When asked what could be done to attract more women to the surgical professions, 42% suggested improved quality of life, and flexibility in part-time pathways with career and training options.

Nearly a third (30%) of respondents said that sexist language should be challenged.

There were reported accounts of discrimination by patients who made implicit assumptions that it was unacceptable for a woman to be a surgeon. One respondent commented: "Patients are often shocked that I will be doing their operation." Another said: "Significantly more patients call me nurse or lady doctor than any of my colleagues."

Some female surgeons said that with fewer women represented at senior level, this could reinforce the idea that surgery was a male-dominated environment.

The study authors, led by Imperial College London, note that despite females making up 55% of annual intakes for medical schools, only 28% of these women eventually pursue a career in surgery via higher surgical training in the UK. They wrote: "Male surgeon colleagues who already mentor and support females are appreciated, but women, also need to step up and promote themselves.

"The glass ceiling for women in science is created by people, of either gender, and it can only be broken if all are aware of it and change their behaviour and attitude towards it."

The researchers acknowledged that the study results were limited by the small number of participants who were confined to those active on social media platforms. 
 

Results 'Are Disappointing'

Commenting on the results, Prof Farah Bhatti, consultant cardiothoracic surgeon, and chair of the Women in Surgery Forum at the Royal College of Surgeons, told Medscape News UK: "Discrimination of any kind is unacceptable and it is disappointing to hear the women in this small survey highlight the challenges they have faced.

"The survey focuses on perceived barriers to a surgical career for a woman, including concerns around being able to have a family, achieving a work-life balance, and working flexibly. Whilst it is important to understand the types of challenges faced by women, and to address any systemic issues, there has probably never been a better time to pursue a career in surgery. There is no fundamental reason why women cannot succeed in surgery and there are many great role-models.

"It is important to note that there has been a slow but steady increase in women pursuing a surgical career. The percentage of consultant surgeons who are women in the UK has risen from only 3% in 1991 to 12% in 2018."

Bellini MI, Graham Y, Hayes C, et al. A woman's place is in theatre: women’s perceptions and experiences of working in surgery from the Association of Surgeons of Great Britain and Ireland women in surgery working group. BMJ Open 2019;9:e024349. doi:10.1136/bmjopen-2018-024349. Paper.

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