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Patient care undermined by so few women in surgery

Lead surgeon calls on profession to reverse trend

Jo Carlowe

Wednesday, 09 March 2016

A leading surgeon has warned, this week, that patient care could be affected unless the medical profession attracts more women into surgery. 

Currently around 57% of doctors in training are women but only 30% are surgical trainees and 11% consultant surgeons.

Speaking at an event to mark International Women’s Day, the Women in Surgery (WinS) conference at the Royal College of Surgeons, Miss Clare Marx, President of the Royal College of Surgeons and a Consultant Orthopaedic Surgeon, said: “Surgery used to be one of the most sought-after medical specialties. Yet our failure to attract sufficient and growing female trainee numbers is a factor behind why we are now attracting fewer overall candidates into surgery.

“Unless we can reverse that trend and encourage and support more women to access surgery as a career, we risk reducing our choice from the talent pool. Eventually that has the potential of reducing the quality of care that patients receive.”

Referring to recent analysis* published in BMJ Careers, Miss Marx pointed out that while surgery has traditionally been one of the most popular medical careers, in 2014, it was not possible to fill every training post for the 10 surgical specialities.

Although the selection process was as competitive as ever, the ‘fill rate’ for core surgery fell short of other areas of medicine, including: acute care common stem, anaesthesia, clinical radiology, ophthalmology and public health.

Miss Marx added: “I strongly believe that a major factor behind this [fall in the fill rate] is the increasing numbers of women in medicine for whom surgery is still not a popular career option.

“As my surgical colleagues have made clear [in the BMJ study], if surgery continues to be seen as a male dominated discipline and women choose not to apply, we really will be fishing in an increasingly small pond.”

To attract more women into the profession, Miss Marx calls for medical leaders to:

  • Talk positively about the benefits of a career in surgery for women
  • Challenge the perception that a surgical career makes greater demands on your work/life balance than other postgraduate careers
  • Be prepared to talk openly about these issues and offer practical solutions, including supporting men and women in less than full time training so they can balance their work, social and family commitments;
  • Banish ‘all male short lists’ for interview panels and conferences; and
  • Encourage and applaud men and women who sponsor their female peers in surgery

Miss Marx, who became the first trauma and orthopaedic female trainee in London in 1981 and went on to be elected the first female President of the RCS in 2014, told the audience: “In my own career, I am extremely grateful for the guidance and mentoring that I received from men, and I wouldn’t be standing on this platform with you today if it wasn’t for the courageous male and female leadership and support that I have experienced to date.

“That is exactly what we are aiming to do with our emerging leaders group at the College and through the fantastic work of Women in Surgery. These national actions should be promoted and replicated on a local basis as well.”


* Eardley I, Scott H, Wilkinson D. Why a career in surgery is no longer the golden ticket. BMJ Careers, August 2015.

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