Abstract
How do women succeed in medicine? Despite more women being attracted to medicine and more qualifying as doctors, career progression remains difficult in general and is a bigger problem in certain specialties. The explanations are often insulting, and the onus is unhelpfully placed on women’s choices. A career break for children is a woman’s fault, not a failure of the system. Unwillingness to work unsociable hours is a personal failing rather a flaw in the way a service is organised. Some careers are traditionally macho for no other reason than it suits men to keep them that way. The surgical specialties are frequently used as an example, but female patients may prefer being seen by a female doctor, for example, when being screened for breast or cervical cancer.
Megumi Hirayama and Senaka Fernando investigate the organisational barriers for female surgeons to help explain why many women leave surgery before developing their career. 1 Their systematic review identifies two major themes in the current evidence base. First, organisational culture promotes a rigid career structure which favours male domination of the specialty. Second, the pressure on women to strike a work–family balance is not eased by the career structure in surgical specialties. The authors warn that the evidence base lacks detail about work patterns in relation to part time and flexible working, and the strengths and weaknesses of these options need to be explored. But in the year of #MeToo, this month’s research paper provides important insights into the career barriers women face.
Winston Churchill’s success was influenced by health problems. JRSM now only rarely indulges in medical biography but when, as David Werring explains, the individual is one of the most significant political figures in British and world politics in the 20th century it seems sensible to make an exception. Following up an article at the end of 2017, 2 John Scadding and Allister Vale begin a new series on Churchill, his illnesses, and the political implications.3,4 It is also a series that focuses on the senior doctors seeking to care for their precious patient. They were, of course, the best known in their field but inevitably male.