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Widening gender gap threatens hard-won gains for women in surgery
The Royal College of Surgeons (RCS) has warned that progress for women in surgery is at risk of stalling, as the latest data analysis has revealed a growing gender gap in applications to surgical specialty training and a drop in the number of women accepted into fields like Trauma and Orthopaedics (T&O). Official NHS data on the number of men and women applying for surgical training posts shows that women are proportionately more likely to be accepted onto surgical training programmes, and more women than ever are applying. In 2021, women secured almost 37% of surgical training posts, rising to 40% in 2024. However, the ratio of male to female applications
to surgical training posts has increased from just over 1.71:1 in 2021 to 1.95:1 in 2024, despite women outnumbering men in UK medical schools. Some specialties, including T&O, are becoming more male-dominated. Application rates for this specialty remained consistent between 2021 and 2024, with roughly five men for every one woman who applied each year. Despite this, the ratio of males to females accepted to T&O training programmes increased from 2.41:1 in 2021, to 4.93:1 three years later.
In addition, there is emerging evidence that women are less likely to experience opportunities
to operate on patients. This is despite evidence that women have better operative outcomes than men. While the cause is unclear, contributing
factors may include an increase in applications by international medical graduates and men making a larger number of applications per applicant than women. Last week, the NHS announced changes to limit application numbers to five per applicant. Women remain significantly underrepresented
in surgery. On average, for every female consultant surgeon, there are currently five male consultants. No surgical specialty has more than 29% female consultants; in some, such as T&O, the figure is below 9%. Speaking at the Women in Surgery’s ‘Women at the Cutting Edge’ conference in Birmingham, Professor Felicity Meyer, Consultant Vascular Surgeon and Chair of the Women in Surgery (WinS) Forum at RCS England, said that while the data “tells an important story of progress, even if slow”, it also “highlights major risks to progress”. She warned that the government risks stalling progress if forthcoming workforce and training plans do not support women in the profession. Professor Meyer also highlighted the ongoing barriers facing women in the profession, from early perceptions about the culture and compatibility with personal life, to the practical challenges of flexibility, visibility, and career progression. She warned that “to retain the very best surgeons, for the future of the profession and for the future of the NHS, surgery must be a career that welcomes, supports, and sustains everyone who chooses it.” RCS England is calling for the UK and devolved
governments, and the NHS to prioritise: l Modern training models: Deliver greater flexibility and better support for work-life balance and portfolio careers, enabling part- time working, and training programmes that reflect the needs of trainees.
AI trial highlights major savings
The largest artificial intelligence (AI) trial of its kind globally in healthcare, involving more than 30,000 NHS workers, has shown how new technology could generate unprecedented time savings for NHS staff and lead to better care for patients, in a major productivity drive. A groundbreaking pilot of Microsoft 365 Copilot
across 90 NHS organisations found that AI-powered administrative support could save NHS staff on average 43 minutes per staff member per day or more - that’s five weeks of time per person
annually. Results from the trial show that a full roll-out could save up to 400,000 hours of staff time per month, equating to millions of hours every year, enabling staff to focus more effectively on frontline care. The NHS estimates that the technology could
save it millions of pounds every month based on 100,000 users, which could reach hundreds of millions of pounds in cost savings every year - cost savings that would be spent on directly improving patient care and frontline services.
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l Supportive return to work policies: Implement policies to support individuals to take leave and return to work regardless of their career grade, gender or specialty.
l Job planning reform: allow greater flexibility in job plans and rota structures.
l Cultural change: Challenge stereotypes in surgery and medicine, and stigma around flexible working including parental and caring leave and highlighting that part-time or flexible working enables committed clinicians to provide excellent patient care.
l Address sexual misconduct within healthcare: Strengthen support for targets of enhance reporting of sexual misconduct in the NHS, as set out in RCS England’s Turning the Tide policy brief.
The professional body also recognises its own role in ensuring women are supported to achieve successful and long-lasting careers in surgery, and leading cultural change. Some of the support for women in surgery RCS England provides includes: l Mentoring: RCS England has recently launched a new mentoring scheme for women in surgery.
l Women in Surgery (WinS) Forum: Consisting of both elected and invited members, the forum works on projects from guidance development to event planning and advocacy for women in surgery. Members represent WinS on the College Council and other committees.
l Emerging Leaders Programme: Designed to support women and non-binary individuals in enhancing their leadership potential in the surgical field.
l Requirement for Vice President to be a woman: Recent reforms to College governance will ensure that at least one Vice-Presidential place always goes to a woman to ensure leadership representation.
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