NHS: Are Female Surgeons Better?

Anyone undergoing surgery wants to know what will increase their survival chances and reduce the risk of complications. Many factors affect the outcome, from hospital and staff to overall health and diagnosis but now there’s another element to consider: gender. New evidence published by the British Medical Journal suggests the gender of the surgeon could have an effect on the outcome.

The Sex of Your Surgeon

The study looked at the post-operative outcomes for both male and female surgeons. Researchers carefully matched similar patients with the same conditions to practitioners of each gender. They then looked at the number of deaths, re-admissions and complications for 104,630 patients treated by a total 3314 surgeons.

The results showed that female surgeons had “a small but statistically significant decrease” in the rate of deaths within 30 days.

In short, if you want to tilt the odds in your favour ask for a female surgeon. The only problem is there really aren’t that many of them to go around.

Women make up more than half of all medical students in the UK. In 2016, 58% of those accepted onto medicine and dentistry courses were women but in the same year women made up just 11% of consultant surgeons in England.

The Royal College of Surgeons says that despite the number of female consultants being on the rise (up from 3% in 1991) the increased number of female medical students “does not appear to be translating through” into surgery. Female representation differs wildly across the various types of surgery; if your child needs an operation you have better odds. The proportion of female consultants in paediatrics is 26% but that plummets everywhere else; around 8% for cardiothoracic (heart and lungs), 7% for neurology and 6% for trauma and orthopaedics.

Nature or Neglect?

Some believe these numbers simply reflect the female preference. In 2014, Professor J Meirion Thomas – an older, male surgeon writing for the Daily Mail – claimed that women in hospital medicine “tend to avoid the more demanding specialities which require greater commitment, have more antisocial working hours and include responsibility for management”.

He argued that the increase in female doctors would be the downfall of the NHS given their desire to have children, go part-time and retire early.

The British Medical Association responded with a heated letter calling him “out of touch with the realities of our modern healthcare system” and saying that “we should be looking closely at [the] disparity in pay, rather than pointing the finger at female doctors for the state of the NHS”. We must look closely at surgery too; why is it so unattractive for female medical students?

Around the world, surgery has always been known as a “boys club” – so much so that the Royal College of Surgeons has a national initiative dedicated to encouraging women into the field. Research has revealed that while unfriendly work hours can be a barrier, it’s not the biggest factor keeping women out of surgery.

Dr Kim Peters found that what women were lacking wasn’t career ambition or the ability to make sacrifices but good role models and a belief that they could succeed in such a male-dominated field. Female medics see that few women have climbed the surgery ladder they so are put off trying it themselves. That is reinforced by their interactions with so many male surgeons. In med student’s eyes, being a surgeon means being male.

Changing The Way We Operate

It doesn’t help that surgery encourages male domination with a sexist culture and “locker room” behaviour that consultant urological surgeon Jyoti Shah called “a hostile environment for women”.

She cited examples of female surgeons being referred to as “nurses” and being asked to make tea by male colleagues, never mind cases of distracting sexual harassment taking place mid-operation, which could endanger lives.

A change in the culture is clearly long overdue, for everyone’s benefit. That doesn’t just mean making male colleagues more welcoming but the terms, pay, hours and conditions of surgery too. With all these obstacles, women still pip men to the post in successful surgeries – just imagine what they could do without them.

by Jo Davey

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