10 January 2014
A recent article by surgeon Professor J Meirion Thomas in the Daily Mail angered College members and galvanised some of you into writing to me.
I can fully understand why. I too was very concerned at the tone and content of the article. I have enormous respect for Professor Thomas’ contribution to soft tissue sarcoma surgery but I have a major problem with his foray into gender politics and the medical profession. Although he pointed out that some of the best doctors he works with are women, the general tone of his argument was unhelpful and in my view, it missed the point.
It is unarguable that one of the most significant changes to medicine in recent years has been the rise in the number and proportion of female doctors. In 2012, according to GMC figures, female doctors represented 61% of doctors under 30 years old, and 46% of those aged 30-50.
Prof Thomas claimed the increasing proportion of young female doctors is having a negative effect on the NHS because most women doctors end up working part time and then retire early. In fact, NHS Employers have recently highlighted that women may make up 66% of the part-time workforce, but that 83% of female doctors work 30 hours or more. Is this really just an issue for women? In terms of surgery, we also know from our last surgical workforce census that over 30% of all consultant surgeons indicated they would like to work part-time at some point in their career suggesting that this is an issue for both sexes.
We also know that the proportion of female specialists is changing. Although female doctors were still under-represented on the Specialist Register in 2012 (69% male v 31% female) the number of women specialists increased by 18% in just the five years up to 2012.
The NHS needs to attract the best people and to give both men and women an opportunity to fulfil their potential. It is also crucial that the composition of the medical profession mirrors the demographics of the society it serves including gender and ethnicity. We have made great strides in this direction with 60% of medical graduates being female. Does Professor Thomas really think we should go back to the days when UK medical graduates were predominantly white males?
This relatively recent change in the gender composition of medical graduates means that we can no longer cling to antediluvian concepts. It means the NHS must change how it works; doctors and surgeons of both genders demand more flexibility and the best will go elsewhere if we do not provide this.
It is true, however, that we still need to do more to encourage women to become surgeons. Progress has and is being made as the specialist register figures show: the proportion of women choosing surgery and reaching consultant level is rising year-on-year (from 4.7 per cent in 2001 to 9.24 per cent in 2012). But comparatively small numbers of women choose surgery as a career and for those who do, few become consultants.
The point that Prof Thomas failed to make is that this shift in workforce demographics does not make women culpable in some way. It is up to us as a profession - and medicine as a whole - to look at why women may be deterred from becoming surgeons or other specialists and find ways to overcome any barriers they face.
Research suggests that a lack of visible role models in surgery may discourage women from considering surgery. At the College, we have five women on the Council who are all excellent role models and who are keen to make an impact in this very important area. Surgery needs to attract the best male and female candidates. Those of us who have been fortunate enough to enjoy a career in surgery have a responsibility to encourage younger generations to apply to the profession. If we don’t do this we will fail to attract the brightest and best and our profession will suffer accordingly.
Our Women in Surgery (WinS) group works to ‘encourage, enable and inspire women to fulfil their surgical ambitions’. The team has piloted a peer mentoring scheme for women, where medical students have been mentored by foundation-level trainees who were in turn mentored by trainees at the level above themselves, continuing up to consultant level.
We should all be thinking about flexible working patterns and training which we know would help all surgeons and if applied appropriately should not affect and indeed could improve patient care. Equally importantly, we must all consider how we can positively influence the attitudes of our colleagues and juniors to attract people of both genders, and from all backgrounds, into surgery.
The Women in Surgery (WinS) website can be found at: www.surgicalcareers.rcseng.ac.uk