“MWF supports women doctors to thrive at all stages of their career and aims to improve health in general. What should MWF focus on over the next five years?”
By Sameera Oruganti
Since 1996, more than half of British medical students have been women (1). We have come a long way since the first female doctor, Elizabeth Anderson, faced strong resistance to her entry in 1865. Despite this progress, women still face unique challenges in the medical field. This rings particularly true in surgery, with less than 17% of surgical consultants being women (2), suggesting that women in surgical training either leave the field or struggle to advance to consultant roles. This is a worrying trend, especially as it has become increasingly clear in recent years that having equal representation across the genders in medicine is vital in ensuring good patient outcomes (3). This essay explores how the Medical Women’s Federation (MWF), as a networking and advocacy body, can help address these barriers by focusing on two key
areas:
- Attracting women to surgery
- Improving retention and progression of women in surgery to consultant role
Attraction
For many medical students, the decision to pursue surgery starts early, with studies showing that 65% of students follow the speciality they favour in university (4). A significant factor in shaping career choices is exposure to role models (5). However,
surgery has long been stereotyped as a masculine, high-pressure field, deterring many women from even considering it (6). This creates a negative feedback loop: fewer female surgeons mean fewer role models, which in turn discourages women from identifying with surgical careers. Research supports the idea that exposure to female role models can help; women are significantly more likely to pursue surgery if they train in environments with a high number of female surgeons (7). MWF can leverage this by partnering with medical schools and societies to provide surgical mentors across various specialities. These mentors can offer guidance, organise theatre experiences, and help students build their portfolios in a supportive, safe environment.
Retention & Progression
Retention and progression are crucial areas where MWF’s influence can make a substantial impact. Two primary challenges are the lack of run-through training programs and the decline in technical skills among trainees.
The severe bottleneck in core surgical training (CST) has been evident for some time now, with far fewer speciality training posts available than in core surgical (8), as demonstrated by Table 1. 
This bottleneck affects women disproportionately, evidenced by a larger attrition rate from CST (9). One potential solution is the introduction of more run-through training programs, where foundation doctors can transition directly into speciality training. These programs offer a more predictable career pathway, which may appeal to women seeking work-life balance and the possibility of starting families during training. The success of obstetrics and gynaecology and ophthalmology, both run-through specialities with the highest percentage of women, demonstrates the value of this approach (10). Run-through programs also help improve job satisfaction. By spending more time in a chosen speciality, trainees develop greater technical expertise and confidence early in their careers, which in turn enhances their long-term progress. Furthermore, these programs could mitigate the challenges posed by reduced working hours, as trainees would have a longer period to hone their skills.
Surgery is a craft speciality and requires skill development to progress. Studies show a decreasing trend in time spent by trainees on basic surgical skills and experience (11), especially amongst less than full-time (LTFT) trainees, many of whom are women. The European Working Time Directive has contributed to this issue by limiting working hours without adequate compensatory training time, exacerbating the skill gap for trainees (11). MWF can advocate for policies ensuring that LTFT trainees have access to the same opportunities to develop technical skills as their full-time counterparts. Educational
supervisors should be encouraged to ensure these opportunities are accessible during normal working hours, in accordance with the Intercollegiate Surgical Curriculum Project (12), making it easier for trainees to complete portfolio-building tasks without sacrificing personal time. Trainees ideally would be allocated dedicated lists with a limited number of patients so they can be adequately taught by seniors. Aiming for a mix of cases for each list would ensure LTFT employees do not routinely miss out on a type of opportunity.
While women have made significant strides forward in medicine, surgery remains an area with considerable gender disparities. MWF has a unique opportunity to drive change in the attraction, retention, and progression of women in surgery. By fostering mentorship programs, advocating for run-through training pathways, and ensuring equal access to technical training, MWF can help break down the barriers preventing women from reaching consultant roles. These efforts are not only essential for the career advancement of women but also for the overall improvement of healthcare, ensuring
that the surgical field reflects the diversity that benefits both practitioners and patients.
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