Women in surgery: ending patriarchy

Abstract

Women in medicine are fighting back. That doesn’t mean patriarchy in medicine is dead, but it does mean that steps to achieve equality have begun. The moves in clinical medicine are echoed in global health. Conference organisers are now publicly shamed on social media for inviting male dominated panels, or manels. Boards of NHS organisations and medical journals are scrutinised for diversity. The world of medicine may not feel different today but it inevitably will in a decade.

These developments are to be supported. But perhaps the most impenetrable culture of all may be that of surgery. The bias against women in surgery is conscious and unconscious. The surgeon of folklore, say Bellini et al., ‘is male, Caucasian, busy, heroic, selected for perfection, sometimes grumpy when seeing sub-optimal performance in others, often inadvertently bullying.’ Little wonder, then, that women don’t see themselves as a surgeon.¹ Nor do they see themselves on the walls of surgical colleges and departments, where members of the good and great are invariably men.

But surgery, like any specialty, will be better for greater representation from women. We must change the surgical norm, argue the authors, to a more diverse and inclusive environment. The keys to this are mentoring, support during and after maternity leave, time out to pursue an academic career, work--life balance and pay parity.

The world of surgeons is well represented elsewhere in this month’s issue, albeit by male authors. Our thoracic surgery series provides an overview of ablative therapy in lung cancer.² Meanwhile, Winston Churchill loses his appendix and his ministerial office.³

If you’ve had your fill of surgery, you might explore our mini-theme on Italian history? Davide Lazzeri and Carlo Rossi explain why Leonardo da Vinci’s right hand reveals an ulnar neuropathy,⁴ and Silvio Garattini explores the significance of Italian trials for prevention and treatment of malaria.⁵

We finish by returning to clinical practice. This time, physicians fight back with an opinion piece arguing that loss of continuity on the medical take has repercussions on both sides of the doctor--patient relationship.⁶

References

Bellini MI, Adair A, Fotopoulou C, Graham Y, Hutson A, McNally S, et al. Changing the norm towards gender equity in surgery: the women in surgery working group of the Association of Surgeons of Great Britain and Ireland's perspective. J R Soc Med 2019; 112: 325–329.

Chia BSH, Landau D, Hanna G and Conibear J. Thoracic intervention and surgery to cure lung: an overview of stereotactic ablative radiotherapy in early and oligometastatic lung cancer. J R Soc Med 2019; 112: 334–340.

Vale JA and Scadding JW. Winston Churchill: acute appendicitis in October 1922 (‘I had lost not only my appendix but my office as Secretary of State’). J R Soc Med 2019; 112: 341–348.

Lazzeri D and Rossi C. The right hand palsy of Leonardo da Vinci (1452–1519): new insights on the occasion of the 500th anniversary of his death. J R Soc Med 2019; 112: 330–333.

Garattini S. Italian controlled trials to assess prevention and treatment of malaria, 1900–1930s. J R Soc Med 2019; 112: 349–353.

Apps A, Farida H and Banerjee R. The loss of continuity has repercussions on both sides of the patient–doctor relationship: reflections from the medical take. J R Soc Med 2019; 112: 354–355.