8 February 2019
New research released today by surgeon Dr Rhea Liang provides
insights into why so many more surgeons are men than women, despite
the increasing number of women in medicine.
Download full media release (PDF 104KB)
In the UK and Australasia, women account for just 11 per cent of
consultant surgeons despite the fact that approximately 60 per cent
of medical students are women.
The research confirmed factors identified in earlier reports as
reasons women leave surgical training, and contributed six new
factors: unavailability of leave, a distinction between valid and
"invalid" reasons for leave, poor mental health, absence of
interactions with other women in surgery, fear of repercussion, and
lack of pathways for independent and specific support.
The qualitative research titled Why do women leave surgical
training? A qualitative and feminist study, was conducted by Dr
Liang, a General Surgeon, in conjunction with Professor Tim Dornan,
of Queens University Belfast, UK and Professor Debra Nestel of
Melbourne University and published by leading medical journal The
Lancet. It asked women to describe in-depth why they had chosen to
leave surgical training soon after they had started it, despite
having aspired to the profession since childhood.
"They leave because of various stresses, which accumulate like a
tower of stacked blocks. Eventually, an individual's tower can
reach a height that it will topple in the absence of efforts to
stabilise it, often the final 'toppling' precipitator appearing
relatively minor," says Dr Liang.
The research also found that by analysing 'leavers' experiences in
depth, it was possible to see how these factors discriminated
selectively against women.
"Our findings suggest that women might be better helped by
interventions that do not focus unduly on gender. These
interventions are likely to improve surgical training for both
women and men because many factors, such as long working hours and
unpredictable lifestyle affect all trainees, and changing societal
expectations mean that previously female factors, such as
childrearing, are increasingly shared," Dr Liang said.
Dr Liang also wears another hat as Deputy Chair of the RACS
Operating with Respect Committee, which looks at how cultural
change can be effected in the surgical workforce.
"I am fortunate to have a role with RACS to reshape the culture of
surgery on the foundations of collaboration and respect. This also
means dealing with unacceptable behaviours as we strengthen
surgical education and training. It is not going to be a quick fix
and we know this is a long-term investment and that we need to