Consultant Surgeons in the UK - Essay Example

of the Ayse Gulcicek Supervisor: Dr J. HAWARD Why do women only make up 6.5% of consultant surgeons in the UK Word Count Total: 2256 Word Count Abstract: 128 Abstract Surgery is an enticing medical profession which historically had been the prey of gender discrimination. Surgery traditionally had been a male-dominated area of medicine, whereas the work involves artistry of fingertips. There are several reasons as to why this had been primarily a profession of male doctors; one of them is social reason of females needing to devote more time in families. Despite advancement in society, improvement of outlook, shift of responsibilities in families, even now, only 6.5% of the consultant surgeons in the UK are females. In this discourse, evidence from history and research in this area has been presented to be able to find out the reasons for this. The idea of such a work is to find out the reasons for this, so some solutions may be suggested in order to change the present scenario. Introduction Feminine has always been regarded to have less status and power and has always been subordinate.. Perhaps due to this reason, although these sex differences in earnings, occupations, and work in the United Kingdom have decreased over the past few decades, sharp differences still persist. Like in any other profession, the women now constitute a large force in terms of number and quality in the medical profession. However, there is a certain pattern of their choices of discipline, especially when the numbers of female professionals in different specialities are considered. The greatest convergence between women and men has occurred in labor force participation (Buyske, 2005). Yet despite this increased participation-and this may help to explain the slower progress with respect to wages and occupational segregation-women, on average, devote far more time than men to housework. The Case of Surgery as a Profession One medical profession is surgery, or more specifically general surgery, where particularly male predominance has been observed. As of now, as statistic indicate only 6.5% of the consultant surgeons in the United Kingdom are women. The question is why does this occur Is there any social reason for this It would be interesting to find out these reasons so the factors responsible for this may be identified categorically. In this work, the answers to these questions will be attempted to be found out through evidence from literature. Broadly speaking, this research covers two areas of inquiry. The first attempts to understand the sources of sex differences in labor markets in the context of surgery as a profession without resorting to explanations based on labor market discrimination. The dominant focus would be on how family economic decision making regarding the allocation of time and human capital investment may generate the observed differences between women and men in occupations, participation, and nonmarket work. The second area of concern could be existing discrimination and male predominance that might have led to a situation where female doctors are comparatively less interested in pursuing a career in, otherwise, exciting surgery. History of Women in Medicine Historically, women doctors are simultaneously a part of medicine and have been placed outside it, and their presence in large numbers is actually a destabilizing one. Surgery as a medical profession had always been seen as a symbol of masculinity, and that rests on an opposition between women and medicine. The century long history of medicine suggests that for long western culture was patriarchal in that it did marginalise women in the profession, reluctant to accept them on the same platform, and women as doctors have faced major hostility from the so called social dominance of masculinity. In fact, for quite some time, women were banned from joining surgery. Male Oriented Power and Privilege It had been previously conventional that medical power and privilege were male oriented; the operations and status of the profession in the medical fields had been dominated by masculinity so as to be called as male medical power, indicating obvious patriarchy and gender inequality. With the restructuring of the of medical work and the shift to group practice, doctors in the postmodern era had to rethink their relations with patients, with each other, and with the health professionals who work alongside them. It is interesting to note that surgery as a profession had had immense modification over time, and the present situation is that it demands long hours to a make a decent living. Often the surgeons end up performing routine work, and more often, they perform it through the night, not because they are dealing with emergencies, but because with limited resources, this is the only time, a theatre is available. In the modern world, work, medicine, and gender relations are dramatically repositioned (End et al., 2004). Social Changes Social changes have promoted more and more women to enter into medicine, which had been unsettling to medical authority, overall organization of work, to the relation between public and private worlds, and to the condition of modernity. The trends in the West demonstrate that women are concentrated generally to general and family practice, with some preponderance in the preclinical or gynaecology and obstetrics. Sometimes, they are seen in large numbers in community or public health. They have made some impact on paediatrics, psychiatry, pathology, anaesthesia, and they have made large impacts on small specialities such as dermatology. If the present trend is correct, they are moving into newer specialities such as geriatrics, rehabilitation, medicine, and genetics. At the same time, they had been notoriously absent from surgery (Krizek, 2002). Condition in the UK In the UK, they remain a tiny minority of surgeons and are seriously under-represented in other procedural specialities. There is, however, a tendency to explain this discrepancy in both individual and institutional terms. The gender-related social preferences dictate that women are better at people work or emotion work and hence choose those areas. The second is women have made long-term investment decisions about their human capital by balancing their domestic and occupational roles. Medical culture is resistant to adapting to the needs of those who have others to care for. It is somewhat true since women have traditionally spent considerable time for the family and children. Indeed caring for children will always be difficult to combine with occupations where dedication and competence are seen to reside in full-time commitment and long working hours (Pastena, 1993). Analysis of Reasons With an attempt to find out and analyse these reasons more closely, the main reasons that have been cited are surgery is a male-dominated field; it needs long hours and family sacrifices, which the women are not ready to do. For their own specific reasons, women are reluctant to enter a profession that needs intimidating hours, whereas, in reality they would prefer to work 3 days per week part time (Davis, 1998). Like any human being, the woman as a surgeon, if they at all plan to have family and children, cannot imagine themselves performing surgery at the wee hours. The second determining factor is the customer and colleagues. Lay people and many physicians including surgeons still believe that surgery is a man's field. According to some, this perception is changing; however, no one would be able to ignore that this perception is discouraging and intimidating to a lot of women. The lifestyle of a surgeon does not easily permit to the other things that a woman might desire to do, and these other things have traditionally been imposed upon them, having a family, being a wife, and a mother. Since representation is less, there is no pioneer, and hence role models in the society are lacking (Dresler et al., 1996). Some have suggested that surgery as profession has in-built military ethic, where junior residents often face yelling and humiliation, and this hierarchy and dominating mentality must be accepted if one wants to be a surgeon, and this may be off-putting the female medical students. On the other hand, many female medicos are afraid that they would not be accepted in a surgical programme of curriculum (Koso, 2002). Even if a female resident opts for surgery, they are taken very lightly, and hence they are not mentored or encouraged to pursue, and thus they end up getting fewer excellent performance ratings in surgical rotations. Associated with this, there are physical challenges of typically women having smaller physical stature and on average weaker muscular strength, can act as subtle barriers. Most surgical instruments have been designed with the standard male operators in mind (Jones, 2000). Present Status It is a fact now that the number and representation of women at entry into the medical school are almost equal to men, but many fewer women go into surgery. Women are very rare in the highest levels of academic surgery, the executive committee of societies, and in full professorships as it applies to surgery. Women residents in surgery are less likely to have marriage, family, and children in comparison to their male counterparts, even though they want to have those. There is also an overwhelming likelihood that women surgeons would be married to other full-time professionals, but they would end up spending more time in household chores and child care at home in comparison to their male counterparts (Hoover, 2006). Surgery as a Medical Profession Even for men, for many years there was an expectation that they would not be married; later when marriage was acceptable. Family was expected to stay out of the way of surgeons. It has been commented that "introducing visible family in the form of pregnant surgeons" has been interesting, but it would be very difficult for the family of the patients, colleagues, and the female surgeons themselves. History has proof that early woman surgeons hid their femaleness by disguise, remaining single, or at least child free to work like men. Although male surgeons and residents have children very commonly, a pregnant surgeon or surgical resident can be shocking to many. Surgery, without doubt, is a macho field. The first formal surgeon's guild in the West specifically excluded carpenters, smiths, weavers, and women. Despite that women have practiced surgery since the ancient times, being at times formally excluded and marginalized. However, those who are pioneers had never felt that there are any barriers for pursuing this form of career (Jonasson, 1993). Surgery indeed is a special career that attracts special people who are more likely to have the skills to keep all, leaving nothing, and reality tells us that many successful women as surgeons could juggle multiple balls keeping many of them at the same time in the air. However, it is acknowledged that as a woman, it is very comfortable to work in company with other women, which is not possible or encouraging for the average woman to choose a career that is male dominated. They would often be the only woman in the room, be mistaken as the nurse, be needed to change in the nurses' room, and this would be the situation unless many more women choose this challenging career path (Colletti et al., 2000). Women in Surgery Women in academic surgery often feel that they are excluded from mentoring, informal networking, and collaboration leading to hindrance in their advancements. This might have been just a perception, but the issues are not less important. This sense of exclusion could have been operative to send a negative message to the future generation, creating barriers for newer entrants (Mayer et al., 2001). Although life style considerations have been implicated frequently, studies have proved that women are deterred from entry into surgical career due to lack of role models. This is significant since the recent trends suggest an increased need for the general surgeons from the future generations, while there is a steady decrease in the percentage of medical students who are entering general surgery residency and the waning interest in a surgical career among medical students. Approximately half of the medical students are women, who are as has been seen very much less inclined towards a career in surgery. A study by Gargiulo et al. (2006) attempts to investigate the deterrents which are functional in promoting women to opt out from surgery. The e-mail survey conducted by the authors revealed that women opt out of surgery due to various reasons. Some of these are diminishing rewards, increased number of lawsuits, lifestyle during residency, family concerns, reimbursements, workload, levels of stress, lack of role models or mentors, a mismatch of profile with the surgeon's perceived personalities, perception of surgery as an "old boys club", and lack of women in surgery. A considerably high proportion of women cited lifestyle mismatch as the main reason. In this study, where males also responded to the survey, it has been revealed that lifestyle is clearly not just a women's issue. Statistically, women are less likely to cite family concerns or be deterred by the surgical workload. The concerns for diminishing rewards also do not hold ground since it has been found that women are about 5 times less likely to be concerned about diminishing rewards (Gargiulo et al., 2006). Conclusion Despite the small representation in the pool of surgeons in largely male dominated discipline of surgery, at last there is evidence that women are breaking the path of traditions and perceptions. As time is going on, there is a general shortage of surgeons, while a gradual increase in the number of women coming into the medical profession. Women can pursue surgery as a career and can do good, as has been demonstrated by the pioneers in this field. Lifestyle of surgeons is an issue, but before anything women need to change their traditional mindset that surgery is an all-male show. Reference List Buyske, JO, (2005). Women in Surgery: The Same, Yet Different. Arch Surg; 140: 241 - 244. Colletti, LM., Mulholland, MW., Sonnad, SS., (2000). Perceived Obstacles to Career Success for Women in Academic Surgery Arch Surg; 135: 972 - 977. Davis, K., (1998). Pygmalions in plastic surgery. Health (London); 2: 23 - 40. Dresler, CM., Padgett, DL., Mackinnon, SE., and Patterson, GA., (1996). Experiences of Women in Cardiothoracic Surgery: A Gender Comparison. Arch Surg; 131: 1128 - 1134. Gargiulo, DA., Hyman, NH., Hebert, JC., (2006). Women in Surgery: Do We Really Understand the Deterrents Arch Surg; 141: 405 - 408. Hoover, EL., (2006). Mentoring women in academic surgery: overcoming institutional barriers to success. J Natl Med Assoc; 98(9): 1542-5. Jonasson, O., (1993). Women as Leaders in Organized Surgery and Surgical Education: Has the Time Come Arch Surg; 128: 618 - 621. Jones, VA., (2000). Why Aren't There More Women Surgeons JAMA;283:670. Koso, S., (2002). Promoting Gender Equality in the Medical Profession: A Physician's Reflection on Her Experiences as a Medical Student. Journal of Health Management; 4: 153 - 166. Krizek, TJ., (2002). Ethics and philosophy lecture: surgery...Is it an impairing profession J Am Coll Surg; 194(3): 352-66. Mayer, KL., Ho, HS. and Goodnight, Jr., JE., (2001). Childbearing and Child Care in Surgery. Arch Surg; 136: 649 - 655. Pastena, JA. (1993). Women in Surgery: An Ancient Tradition. Arch Surg; 128: 622 - 626. End, A., Mittlboeck, M., and Piza-Katzer, H., (2004). Professional Satisfaction of Women in Surgery: Results of a National Study. Arch Surg; 139: 1208 - 1214. Read More