Widening gender gap threatens hard-won gains for women in surgery, warns leading surgeon

Government’s 10 Year Workforce Plan and NHS England’s Medical Training Review must support women to pursue and sustain long-term surgical careers

Progress for women in surgery is at risk of stalling, as new data analysis reveals a growing gender gap in applications to surgical specialty training and a drop in the number of women accepted into fields like Trauma and Orthopaedics (T&O). The Chair of the Royal College of Surgeons of England’s (RCS England) Women in Surgery (WinS) Forum will issue a stark warning later today. 

Official NHS data on the number of men and women applying for surgical training posts shows that women are proportionately more likely to be accepted onto surgical training programmes, and more women than ever are applying. In 2021, women secured almost 37% of surgical training posts, rising to 40% in 2024. 

However, the ratio of male to female applications to surgical training posts has increased from just over 1.71:1 in 2021 to 1.95:1 in 2024, despite women outnumbering men in UK medical schools. Some specialities, including T&O, are becoming more male-dominated. Application rates for this specialty remained consistent between 2021 and 2024, with roughly five men for every one woman who applied each year. Despite this, the ratio of males to females accepted to T&O training programmes increased from 2.41:1 in 2021, to 4.93:1 three years later.  

In addition, there is emerging evidence that women are less likely to experience opportunities to operate on patients. This is despite evidence that women have better operative outcomes than men.  

While the cause is unclear, contributing factors may include an increase in applications by international medical graduates and men making a larger number of applications per applicant than women. Last week, the NHS announced changes to limit application numbers to five per applicant. 

Women remain significantly underrepresented in surgery. On average, for every female consultant surgeon, there are currently five male consultants. No surgical specialty has more than 29% female consultants; in some, such as T&O, the figure is below 9%. Speaking later today at the Women in Surgery’s ‘Women at the Cutting Edge’ conference in Birmingham, Professor Felicity Meyer, Consultant Vascular Surgeon and Chair of the Women in Surgery (WinS) Forum at RCS England, will say that while the data “tells an important story of progress, even if slow”, it also “highlights major risks to progress”. She will warn that the government risks stalling progress if forthcoming workforce and training plans do not support women in the profession.  

Professor Meyer will also highlight the ongoing barriers facing women in the profession, from early perceptions about the culture and compatibility with personal life, to the practical challenges of flexibility, visibility, and career progression. She will warn that “to retain the very best surgeons, for the future of the profession and for the future of the NHS, surgery must be a career that welcomes, supports, and sustains everyone who chooses it.” 

RCS England is calling for the government’s upcoming 10 Year Workforce Plan and NHS England’s Medical Training Review to be designed with flexibility and work-life balance at their core. This includes encouraging NHS trusts to enable genuine flexible working. 

RCS England’s key calls to action:

RCS England is calling for the UK and devolved governments, and the NHS to prioritise: 

• Modern training models: Deliver greater flexibility and better support for work-life balance and portfolio careers, enabling part-time working, and training programmes that reflect the needs of trainees. 

• Supportive return to work policies: Implement policies to support individuals to take leave and return to work regardless of their career grade, gender or specialty. 

• Job planning reform: allow greater flexibility in job plans and rota structures. 

• Cultural change: Challenge stereotypes in surgery and medicine, and stigma around flexible working including parental and caring leave and highlighting that part-time or flexible working enables committed clinicians to provide excellent patient care.  

• Address sexual misconduct within healthcare: Strengthen support for targets of enhance reporting of sexual misconduct in the NHS, as set out in RCS England’s Turning the Tide policy brief.  

The professional body also recognises its own role in ensuring women are supported to achieve successful and long-lasting careers in surgery, and leading cultural change. 

Some of the support for women in surgery RCS England provides includes:

• Mentoring: RCS England has recently launched a new mentoring scheme for women in surgery. 

• Women in Surgery (WinS) Forum: Consisting of both elected and invited members, the forum works on projects from guidance development to event planning and advocacy for women in surgery. Members represent WinS on the College Council and other committees. 

• Emerging Leaders Programme: Designed to support women and non-binary individuals in enhancing their leadership potential in the surgical field. 

• Requirement for Vice President to be a woman: Recent reforms to College governance will ensure that at least one Vice-Presidential place always goes to a woman to ensure leadership representation. 

ENDS

Notes to editors

1. The latest Medical Specialty Recruitment Equality and Diversity data can be found here: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/equality-and-diversity 

2. RCS England’s full data analysis is available on request. 

3. In March 2025 the General Medical Council (GMC) announced that female doctors are greater in number that their male counterparts for the first time ever in the UK: https://www.gmc-uk.org/news/news-archive/more-female-than-male-doctors-for-first-time-ever-in-the-uk  

4. A recent paper in the Bone and Joint Journal found that 'Male trainees perform more operations with autonomy during orthopaedic training than female trainees. Female orthopaedic trainees assist for a greater proportion of cases than their male counterparts.' Find out more here: https://boneandjoint.org.uk/Article/10.1302/2633-1462.61.BJO-2024-0176.R1 

5. A large study published in the JAMA Surgery journal in August 2023 suggests that female surgeons’ patients have better long-term outcomes: Surgeon Sex and Long-Term Postoperative Outcomes Among Patients Undergoing Common Surgeries | Health Care Workforce | JAMA Surgery | JAMA Network 

6. In September 2025, NHS England announced changes to Medical Specialty Training recruitment for 2026 which will limit the number of applications an applicant can submit to five: https://medical.hee.nhs.uk/medical-training-recruitment/news/changes-to-medical-specialty-training-recruitment-for-2026  

7. Women in Surgery (WinS), by the Royal College of Surgeons of England, supports women across all career stages by encouraging, enabling and inspiring women to fulfil their surgical career ambitions. We believe surgery should attract the candidates with the highest aptitude for surgery, regardless of gender. We aim to raise the profile of women in surgery and generate awareness of important issues; develop guidance, networks and events to support female surgeons throughout their career; engage female surgeons of all career grades with surgery and the College; showcase the varied lifestyles of surgeons including flexible training and working. Find out more at https://www.rcseng.ac.uk/careers-in-surgery/women-in-surgery/  

8. The Women at the Cutting Edge conference, hosted by the RCS England WinS Forum, is taking place at the Birmingham Repertory on Friday 17 October 2025: Women at the Cutting Edge Tickets, Fri, Oct 17, 2025 at 9:00 AM | Eventbrite 

9. The Royal College of Surgeons of England provides world-class education, assessment, and development to 30,000 surgeons, dental professionals, and members of the wider surgical and dental care teams, at all stages of their careers. Our vision is to see excellent surgical care for everyone. We do this by setting professional standards, facilitating research and championing the best outcomes for patients.   

10. For more information, please contact the RCS England press office: telephone: 020 7869 6053/6054/6047; email: pressoffice@rcseng.ac.uk; out-of-hours media enquiries: 0207 869 6056.