05 March 2021 (Last updated: 24 Mar 2021 12:45)
2021 presents an unprecedented time for women in surgery, exemplified by the fact that the BSSH, BAPRAS, BAAPS, and the ABS all currently have female Presidents, with a female Vice President Elect currently in post at the BOA and ASiT. In order to celebrate this incredible milestone, each President has very kindly shared their experience as a woman in surgery for International Women's Day, including how they have challenged and overcome certain expectations and stereotypes in their respective specialties, and their advice for future budding female surgeons. A female Trainee from each Association has also shared their own account to provide a comparison of experience between the generations.
BSSH President - Sue Fullilove
(Consultant Hand Surgeon, Plymouth)
Trainee - Terouz Pasha
(Academic Foundation Doctor, Cambridge)
Why did you choose to pursue a career in your surgical specialty?
Sue: Studying pre-clinical medicine at Oxford I was both awed and inspired by the academic environment and planned to head straight back into research after qualifying. But the instant I hit the wards, the whirlwind of clinical medicine swept me up and I never looked back at the labs I’d left behind. I had wonderful mentors and gurus who inspired me – gentle giants, like Rupert Eckersley, and maestros such as David Evans. I was fascinated by the intricate anatomy of the hand, and I loved the requirement of sometimes needing to operate with power, and sometimes with the most delicate touch.
Terouz: I am currently an academic foundation doctor in Cambridge hoping to pursue a career in Plastic Surgery.
As a freelance artist, being able to use manual dexterity and technical skills to improve a patient’s life has always drawn me to surgery in general. However, when a plastic surgeon in medical school lent me their copy of Harold Gillies’ book filled with sketches and images of reconstructive techniques on wounded soldiers during WWI, I became absorbed in plastic surgery.
What (if any) challenges did you face regarding this decision?
Terouz: My peers have been very supportive and encouraging whenever I share my career aspirations. Unfortunately, I do not always receive the same reception from senior consultants. But this is understandable as there are intergenerational cultural differences and historical barriers to females going into surgery. The process of changing this will not occur overnight and instead of a revolution, the change will be a slow and steady evolution.
Sue: My father was a fine and well-intentioned man and we loved each other well enough, but his aspiration for me was to make someone a good wife. Once I had secured a scholarship at Oxford to study medicine, I took a year out to travel. In Dad’s continued mission to make me ‘a good wife’, he insisted I do a secretarial course and a cookery course instead. Needless to say I defied him to go travelling.
What sort of challenges or stereotypes have you experienced as a woman in your field of work (if any)?
Sue: When I was a clinical medical student, a famous orthopaedic consultant was lecturing us on careers. He showed us a pyramid of the career structure in surgery – lots of house-officers at the bottom, slightly fewer SHOs on the next rung, far fewer registrars, then senior registrars and finally a very small number of consultants at the top. The prospects looked gloomy to succeed and make it to the top. But, the renowned consultant went on to reassure his audience “actually, it’s not as bad as it looks, because foreigners and women fill up most of the bottom rungs of the ladder.” This was not an uncommon view of the time, although I don’t think this particular surgeon was invited to give the careers talk again…
I can’t deny that the surgical training ground was challenging. However, in general, if you worked hard, performed well and were prepared to speak up for yourself, it was possible to survive and thrive. Unfortunately the bravado puts off many potential surgeons even today, we must do more to attract women and minority groups to the profession.
Terouz: The biggest challenge for me so far has been a lack of female mentorship. Whilst mentors come in all forms, it is hard for women to envision themselves having a successful career in surgery if they do not see anyone who is like them. Additionally, there’s a narrative issue of women being asked to choose between prioritising either work or family, which seeks to put women at a disadvantage by confronting them with a binary choice. In reality, there are lots of ways to make these things work.
Aside from barriers, I think there are huge positives to being a female in surgery. Diverse genders and diverse people are better for patients. After all, it only makes sense that the doctors taking care of the patients are representative of the patients they are looking after.
What are the most effective ways to encourage more women to pursue careers in our respective areas of surgery?
Terouz: The more we shine light on women in the field, the more we illuminate the path for future generations. Initiatives such as the Women in Surgery network which supports connecting female surgeons at every grade through networking and collaboration is a great example of a group supporting this push.
For me personally, meeting inspiring female consultant surgeons who are successful and respected in their own right has been hugely powerful. We need to make sure everyone can see women in such positions so that current juniors are inspired to take on similar roles in the future, which in turn creates more positive role models and thus encouraging the next generation of female surgeons.
Sue: Positive female role models are hugely impactful and they should always try and remain accessible to juniors wanting advice or support. The make-up of committees, interview panels, exam boards, and trainee assessment groups is often unbalanced and unrepresentative. This can introduce bias to decisions, test results and appointments which further perpetuate inequality. If committees and panels aren’t diverse, we must suggest an additional member, or a change. If you are female, and the panel is all male, offer to be the representative female.
Legislation has definitely helped – equal pay, shared maternity and paternity leave, and parental leave are all positive moves. We can do our part by both allowing and encouraging male and female surgeons alike to make use of these entitlements. Education about equality, diversity, discrimination and bias is likely to improve our practices in the future and reduce inequality.
Find out more about the experiences of women in surgery at the following Associations/Societies:
Follow Sue and Terouz on Twitter - @TerouzP / @SueFullilove
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