Female surgeons in the United Kingdom experience a number of constraints in their practice, including discrimination and the glass ceiling, according to results of a survey published in BMJ Open.

Although 55% of UK medical school students are female, only 28% of these women go on to pursue a career in surgery. A lack of role models and societal perceptions of this area of medicine as a male profession may have an effect on this.

Maria Irene Bellini, MD, PhD, from the Renal Transplant Directorate, Imperial College Healthcare NHS Trust in London, United Kingdom, and colleagues conducted a confidential, online survey distributed through the Association of Surgeons of Great Britain and Ireland social media platforms on Facebook and Twitter during a 2-week period in October 2017. Participants were female clinicians working in surgical specialties.

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The authors used a mixed-methods approach to analyze data from 81 female participants, 88% of whom perceived surgery as a male-dominated field. More than half of those responding (59%) reported discrimination, and 22% perceived a “glass ceiling” in surgical training. The majority of participants (53%) identified orthopedics as the most sexist surgical specialty. They noted that many women switch to general practitioner training for family reasons, and that the rigid nature of professional requirements precludes consideration of family needs. Others felt that women are less confident in their abilities, which may hold them back. Many participants seemed to feel that although discrimination was common, it could not be proven. Lack of formal mentorships was also cited as a barrier for women.

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Among these barriers, the greatest perceived barrier to women having careers in surgery was the incompatibility with motherhood and childcare commitments (50%). The authors suggest greater availability of daycare facilities and childcare options. They also advocate for increased visibility of female role models, and they note that the personality traits often associated with surgeons are perceived differently when exhibited by men and women, which can affect an individual’s confidence.

The authors also noted several study limitations. Among these was the probability that women who had experienced discrimination would be more likely to respond to an online survey, possibly skewing the data.


Bellini MI, Graham Y, Hayes C, Zkeri R, Parks R, Papalois V. A woman’s place is in the theatre: women’s perceptions and experiences of working in surgery from the Association of Surgeons of Great Britain and Ireland women in surgery working group [published online January 7, 2019]. BMJ Open. doi: 10.1136/bmjopen-2018-024349