Women and Scalpels, Friends or Foes?

By Ahmed Magdi Yousef

Most of women who joined medical schools always chose not to pursue a career in surgery. Although more than 50% of medical students are females, they only represent 7% of consultant surgeons in UK, a very humble figure when compared to the ever-increasing enrollment of females in medical schools.

A research conducted by University of Exeter tried to explore the factors that undermine the contribution of women in surgical practice. Women cited that the long and grueling hours of work as surgeons discouraged them from choosing that practice as it will negatively impact their lifestyle and hinder their roles as caregivers to their children. This may be described as an “Opt-out Revolution” where women sacrifice their ambitions in favor of their familial duties.

The inherent stereotypical beliefs that only dreadful males fit for surgery are overwhelmingly keeping females at bay from enjoying a very rewarding career in medicine. The patient perspectives also matter: most of the patients expect to receive their surgical care from a male surgeon, perhaps believing that females are below par and males are more reliable when using scalpels.

The societal and the psychological barriers had to be abolished by some of the female pioneers who paved a road to their successors to follow in their footsteps. It started more than hundred years ago when the brilliant Eleanor Davies-Colley succeeded to be the first woman Fellow of the Royal College of Surgeons in England. She also contributed to the empowerment of female colleagues in medicine through co-founding the South London Hospital for Women and Children which was almost entirely staffed by women.

More prominent feminine figures started to follow, yet at a very slow fashion. Averil Mansfield is another colossal feminine figure; she was a renowned vascular surgeon, the UK’s first professor of surgery and a former president of the Association of Surgeons of Great Britain and Ireland. Mansfield was active in promoting the cause of women in joining surgical careers by establishing the Women in Surgical Training or (Wist) initiative, “At that time we didn't have an organization in this college that was dedicated to encouraging women, so we began it, to show that the career and the college are open to women. That message, 'You can do it, you are not going to meet antagonism,' might be the very thing women need to hear to encourage them to try it” Mansfield said. Margaret Ghilshick is also a famous female surgeon who fought prejudice to become an outstanding surgeon; her job didn’t influence her family as she is a mother of four and has three grand children. She is also an author, and her book The Fellowship of Women: Two Hundred Surgical Lives highlights the role of women in surgery over a century of hard work and commitment.

Emily Granger is one of only a handful of female heart/lung surgeons in Australia

Today a myriad of initiatives arose to encourage more women to join the surgical practice. Women in Surgery (WinS) is national initiative in UK “working to promote surgery as a career for women and to enable women who have chosen a career in surgery to realize their professional goals”. The unabated work of such initiatives focuses on eroding the idea that surgery is only for “machos”, it is a necessity that women join surgery to enjoy its gratifying outcomes and contribute to saving patients. Julie Freischlag, once the William Stewart Halsted Professor and Director of the Department of Surgery at the School of Medicine and Surgeon in Chief of Hopkins Hospital and now UC Davis vice chancellor for human health sciences and dean of the UC Davis School of Medicine, called for making the surgical environment more amenable for women and encouraged the process of active recruitment of women in residency positions, “There are those who feel only a miracle will allow women to reach their equal representation, not only in surgery but in other fields such as politics and business. But we create our own miracles with a bit of help from our leaders. And our leaders are you and me” said Freischlag. Women have to lead and progress themselves in surgery and time will affirm that women and scalpels are no longer foes!

By Ahmed Magdi Youssef

References:

Peters K, Ryan M and Fernandes H. Attempting the possible: Can ambition explain the underrepresentation of women in surgery? Social, Environmental and Organisational research group, University of Exeter.

Royal College of Surgery, Surgical Careers. Women in Surgery (WINS).

Hartley C. Historical Dictionary of British Women.

Hanson M. First lady of the theatre. The Guardian, Tuesday 30 July 2002.

Collender G. A pioneer at the sharp end of medicine. Birkbeck, University of London.

Freischlag JA. Women surgeons--still in a male-dominated world. Yale J Biol Med. 2008 Dec;81(4):203-4.