Sexism in surgery: it’s time to do something

You would expect women to flourish in medicine.

Since 1996, women have outnumbered men in Australian medical schools. 

More than half of general practice trainees, two out of three paediatric trainees and close to three-in-four obstetricians in training are women.

Look at surgical training and this pattern stops.

Fewer than one-in-three surgical trainees are women and the numbers fall further as doctors reach advanced training.

Just nine per cent of surgeons in Australia are women.

In March, vascular surgeon Dr Gabrielle McMullin unleashed a storm by suggesting sexual harassment was common in surgical training.

She said gaining redress was so compromised that if a female doctor was propositioned, providing a sexual favour may be the only way to sustain her career.

Data from medical schools in the US, the UK and Australia all confirm that sexual harassment occurs in medical school.

A 2005 US study of medical students found 92.8 per cent of female students had experienced, observed or heard about at least one incident of gender discrimination and sexual harassment during medical school.

This harassment continues into specialist training.

Systemic bullying and harassment ranges from crass sexualised jokes, inappropriate touching and crass commentary on female doctors' bodies, to frank requests for sexual favours.

Some of these may occur in public but much is unwitnessed.

Female doctors report they may be able to manage harassment by patients and by their peers but harassment from supervisors is much more difficult to deal with.

Many women doctors are reluctant to come forward and develop feelings of guilt and resignation.

Sexual harassment occurs within a larger culture of discrimination against women in post-graduate medical training.

A recent US study of female surgeons found 87 per cent experienced gender-based discrimination in medical school, 88 per cent in residency and 91 per cent in practice.

When employed, some female trainees report being given job contracts that are structured so they can never meet the criteria for maternity leave.

Others say their rosters make it impossible to carry on with a career while maintaining caring responsibilities.

The toxicity of surgical training arises because it's highly hierarchical, male-dominated, and  – like most hospital-based training in the specialties – involves an intense apprenticeship training mode.