Workforce issues
surely (gasp of dismay from the front of the auditorium). One respondent in the survey reported being refused by a consultant when she arrived to cover a surgery. How could it be possible that a woman is strong enough to work in this very male-dominated surgical specialty? That a woman is strong enough to manipulate and fix bones? Surgical culture wasn’t built with women in mind; it’s still catching up. From the assumption that surgeons must be physically strong, to rigid working structures that ignore caring responsibilities, the system itself excludes women. In a report commissioned by the Royal College of Surgeons, it was found that women were more likely to be addressed by their first names, and correspondence was often addressed ‘Dear Sirs’, as though all surgeons were men.1
But women
shouldn’t have to fit into a model designed for men; it should be redesigned to suit everybody. In 2015, inspired by the #ILookLikeAnEngineer
social media movement, Dr. Heather Logghe encouraged female surgeons to further challenge gender stereotypes by using the hashtag #ILookLikeASurgeon.2
The hashtag
garnered 250 million impressions in its first year, involving over 13,000 participants.3 Two years later, The New Yorker featured female surgeons on its front cover, giving rise to a resurgence of the hashtag with a further 4.7 million impressions.4
The likely reason for the
hashtag’s popularity is that its link to gender stereotypes hit home, and hit hard. The fact that it’s still being used now, particularly by female orthopaedic surgeons, is testament to the slow evolution of the surgical healthcare landscape.5 A quick search reveals that, over the last seven days, the hashtag has reached 301.4K; no small feat a decade after its inception.
With steering committees and leadership The stats
71.43% 88.89%
66.67% 87.5%
of women were explicitly told they were the wrong gender for the profession
structures largely made up of men, it’s easy to see why attitudes aren’t changing.; bias is entrenched through leadership models that lack diversity, and without enough women on panels, these voices are simply not being heard. Visible female mentors and in leadership positions, beyond tokenism, is a critical move. Without female mentors to support students to succeed, how will they know how to navigate this daunting landscape? And without females ahead to inspire, that landscape is pretty discouraging. Accountability is key. Typically, male surgeons
of female consultants reported having experienced gender bias
of female medical students reported having experienced gender bias
of female surgical trainees were discouraged from pursuing surgical careers, being told to, ‘…think about their “future husband and children” before pursuing surgery’.
are not wittingly biased or misogynistic - far from it. However, they need to know when it is appropriate to be heard. Sometimes, their voices need to be quieter, allowing space for female colleagues to speak, to effect change. And, conversely, in effecting change, their voices need to be louder. It’s about being aware, knowing when to speak and when to step aside. They must support female colleagues in meetings, primarily by not speaking over them, and by calling out those who do. They must recognise that they, as do all of us, have implicit biases, and work on navigating and changing them. They must support and drive the redesign of inflexible working patterns. Yes, there are more female medical students than ever before, but what kind of workplace are they entering? This shows progress, but it is precisely this progress that tells us now is the time for further change. Perhaps bias isn’t as simple as male surgeons being unaware; could it be that they’re afraid of calling out misogynistic behaviours? In a 2020 article in Scientific American, paediatric trauma surgeon Chethan Sathya muses, “Like many male surgeons, I have been afraid to speak up out of fear that it would destroy my reputation among senior surgeons in power, who are more often than not men.”6 This hierarchical culture leaves (some) male
surgeons watching on as female surgeons get ‘treated like second-class citizens.’7
Perhaps this
behaviour is so ingrained that it is simply not noticed, or maybe it’s written off as banter. Zeno Franco, associate professor at the Medical College of Wisconsin, comments, “Men are bystanders. They know something is wrong. They know someone is taking advantage of the situation but medical training is hierarchical, and most men find it hard to challenge someone with more authority.” He adds, “Frankly, many male surgeons don’t care enough to do so.” It is not enough that some men do not
discriminate, and it is not enough to be benign; to simply abstain from discriminating. To move forward, all men must acknowledge, and call out, discrimination in the workplace. This
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www.clinicalservicesjournal.com I July 2025
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