Why are there more men than women in surgery?

New research released by surgeon Dr Rhea Liang providesinsights into why so many more surgeons are men than women, despitethe increasing number of women in medicine.

In the UK and Australasia, women account for just 11 per cent ofconsultant surgeons despite the fact that approximately 60 per centof medical students are women.

The research confirmed factors identified in earlier reports asreasons women leave surgical training, and contributed six newfactors: unavailability of leave, a distinction between valid and”invalid” reasons for leave, poor mental health, absence ofinteractions with other women in surgery, fear of repercussion, andlack of pathways for independent and specific support.

The qualitative research titled Why do women leave surgicaltraining? A qualitative and feminist study, was conducted by DrLiang, a General Surgeon, in conjunction with Professor Tim Dornan,of Queens University Belfast, UK and Professor Debra Nestel ofMelbourne University and published by leading medical journal TheLancet. It asked women to describe in-depth why they had chosen toleave surgical training soon after they had started it, despitehaving aspired to the profession since childhood.

“They leave because of various stresses, which accumulate like atower of stacked blocks. Eventually, an individual’s tower canreach a height that it will topple in the absence of efforts tostabilise it, often the final ‘toppling’ precipitator appearingrelatively minor,” says Dr Liang.

The research also found that by analysing ‘leavers’ experiences indepth, it was possible to see how these factors discriminatedselectively against women.

“Our findings suggest that women might be better helped byinterventions that do not focus unduly on gender. Theseinterventions are likely to improve surgical training for bothwomen and men because many factors, such as long working hours andunpredictable lifestyle affect all trainees, and changing societalexpectations mean that previously female factors, such aschildrearing, are increasingly shared,” Dr Liang said.

Dr Liang also wears another hat as Deputy Chair of the RACSOperating with Respect Committee, which looks at how culturalchange can be effected in the surgical workforce.

“I am fortunate to have a role with RACS to reshape the culture ofsurgery on the foundations of collaboration and respect. This alsomeans dealing with unacceptable behaviours as we strengthensurgical education and training. It is not going to be a quick fixand we know this is a long-term investment and that we need tostart somewhere.”

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