This International Women’s Day, we took the opportunity as a College to recognise the vital role played by women all over the world in the surgical profession, many of whom have been working tirelessly over the last twelve months under extremely challenging circumstances, in the global fight against COVID.
We were delighted to host a webinar to mark the special day, where four incredible female speakers discussed their experiences of working in the medical field, and shared the various challenges they have faced at different stages of their career, as well as advice on how others may be able to overcome these hurdles going forward.
We believe it’s absolutely vital to be part of the wider conversation around what it’s like to be a woman in the surgical workforce, and we are committed to lobbying for and promoting change for good when it comes to the issues affecting women in the profession.
We hope that by showcasing these stories, we can give greater insight into what it’s like to be a woman working in surgery, and in turn, more females will be encouraged into the profession.
Dr Judy Evans, a Consultant Plastic Surgeon who was the first female Office Bearer at RCSEd, spoke candidly of her time as a trainee and her career to date. Dr Evans explained:
Women were admitted into examinations at the Royal College of Surgeons of Edinburgh for the first time back in 1871. Up until then, the general consensus was that genteel women could not be exposed to the horrors of blood, guts and infections.
However, that argument was ultimately lost when it was pointed out that the vast major
ity of nurses in those days were female, and they were being exposed to these things while caring for patients as well.For many years, there was a lack of female surgeons who also had a family. Lots of women gave up on the idea of having children, instead focusing on their surgical careers, so it was really up to my generation to see if we could do both.
Initially I studied zoology, then when I decided I wanted to go into surgery at the age of 21, I was continually told I was far too old. Eventually, I received a training opportunity in Hong Kong, and was able to progress my career as a surgeon.
I think things have improved for women in surgery and that’s evident when trainee surgeons who are coming up the ranks now express shock at some of the experiences I went through. It shows things have changed for the better. We’ve made it better for women over the years, and therefore we have made things better for the whole surgical workforce, but there is still much to do.
Kirsty Mozolowski, ST6 in Colorectal and General Surgery and member of the RCSEd Trainees Committee, also spoke about the challenges and aspirations of surgical trainees. Kirsty said:
When considering what it’s like to be a female trainee surgeon, of course you have to consider the impact of COVID-19 and how this has drastically reduced the number of training opportunities available for all trainees.
Female trainees have been disproportionately affected, given that pregnant healthcare workers were sent home or asked to work in non-patient facing roles during the early months of the pandemic. Further guidance was later published which said pregnant women working in medical settings could continue as normal up to 28 weeks, but after that period they should work from home.
This meant that around two to three months of clinical work was completely lost by pregnant trainees. While it was a good opportunity to undertake academic work, we can’t underestimate the impact this has had on female trainee surgeons.
It’s also important to remember that studies regularly show women are more likely to take on the additional burdens of domestic chores and childcare responsibilities, and that your gender, parental status and relationship status all play a role in outcomes for women in surgical training.
Given that over half of medical graduates are female, but less than a third of those go on to become surgeons, it’s clear that more could be done to encourage women into the profession. I think the normalisation of less than full-time training would be a hugely positive step forward, and more people choosing to train this way would quash the remaining stigma surrounding it. Visible role models also play a big part in the recruitment and retention of females in surgery.
I think it’s fair to say we don’t have equality just yet, but we are making good progress. We’ve set up a working group which will look at the RCSEd Council and committees and suggest ways to make them more diverse by increasing representation of all minority groups.
Professor Dame Jane Dacre, President of the Royal College of Physicians, delivered an insightful presentation on the gender pay gap. Dame Dacre explained:
During the junior doctors’ industrial action, Jeremy Hunt commissioned a review into the gender pay gap in medicine. A clause in the equalities impact assessment said any detriment to the cause of women in medicine was OK, because it allowed the Government to achieve a legitimate aim, and as you can imagine this caused absolute uproar.
I was appointed to lead the review, which ended up being the largest ever review of public sector pay and pay gaps. This was partly down to having access to the NHS’s enormous data set which held information on staff members’ salaries and gender.
Lots of people mix up the gender pay gap with equal pay. A pay gap is the difference in average hourly earnings between women and men, expressed as a percentage of men’s pay. It’s not about equal pay for equal work, rather the overall amount of money that is less paid to women in an organisation.
The results were truly shocking. It showed pay gaps in almost every area of medicine, and surgical specialities were amongst those with some of the biggest gaps.
The report also showed that gap gaps worsen with motherhood, something we refer to as the “motherhood penalty”, whereby people who have children tend to lose out on salary development because of the time out taken to have children. It can take until a woman is 65 to catch up, because this is around the age that some men choose to work part-time.
The reasons behind the gender pay gap in medicine are extremely complex, as are the solutions. In the report, we have identified a series of themes and 42 recommendations which could address the pay gap.
The most effective way we can make an impact is by promoting more women. If there are more female consultant surgeons at the top of the ladder, this will reduce the gender pay gap.
Rounding off the event, Ms Clare McNaught, Consultant General and Colorectal Surgeon and RCSEd Honorary Secretary, spoke about overcoming hurdles in your later career. Ms McNaught said:
As you get older and further into your surgical career, you’re often faced with additional pressures in life such as children going into higher education, greater levels of responsibility at work, and your body can take a little longer to recover from such a physically demanding job.
Of course, these things don’t just affect women, but everyone getting to that stage of their life and career. However, menopause is a unique challenge for women, which has a huge impact on mental and physical health. There seems to be a taboo around discussing the menopause, but considering there are roughly 30,000 doctors across the UK going through it at any given time, it’s vital that we open the dialogue.
Last November, the BMA published a paper which showed that 90% of working female doctors going through menopause have been impacted significantly as a result. Almost 50% feel they’re unable to talk about it as they don’t want to be seen as inadequate, and 36% had decided to go part-time as a result.
As well as the physical effects, menopause can greatly impact your mental health and cause symptoms such as anxiety and a lack of confidence, which is extremely problematic when working as a surgeon and confidence is absolutely vital.
One in four medics are currently over the age of 55, and with so many considering early retirement, I believe it’s vital that we improve workplace culture in order to retain more professionals at this later stage of their careers.
If we make it better for women, we make it better for everyone in surgery, which is exactly what we want. As a surgical college, we will continue to work with Government and employers to ensure our members are supported, allowing them to have happy, full and productive lives.