Overcoming Barriers, Hurdles and Stumbling Blocks

Our last few posts have highlighted some of the barriers women in the workplace in general or in surgery in particular face. However, these barriers are by no means insurmountable. Here is the take of some women in surgery on overcoming these barriers:

“I know when I first started I was like ‘Oh my gosh, there are so many hurdles’, but they’re fun hurdles and they’re hurdles that you do with other people. So I’d say get some good work experience … speak to people who are doing that job day to day, find out what it entails. There have been loads of work experience people coming around recently and you just talk to them and say ‘this is what we do, are you interested in that? Okay, come and watch me do this’. And it gives them a bit of insight into what they are in for and hopefully it inspires a few people that it is not too difficult, that it is achievable.”

“I think WinS is absolutely fundamental to women centred issues around pursuing a surgical career. I’ve been at lots of conferences where we talked about maternity leave, breastfeeding, how do you operate when you’re pregnant… and answered a lot of questions and anxieties that women surgeons have that they just can’t ask in the workplace because there aren’t other women to ask. And also just the practicalities of how you manage pregnancy and how you manage childcare afterwards – there are hundreds of examples in the WinS organisation. They just need to come to our meetings or just tap into it and there is a wealth of information there. And then they go away having come with what seemed to be an insurmountable problem going ‘well, what was all that about? All these ladies made it seem really easy and if they can do it, there is no reason why I can’t do it.’.”

“Babies, pregnancy – how do you operate when you are quite far away from the table? But actually I noticed that some of my male colleagues were the same size already and they didn’t have a baby in them. So I thought ‘well, if they can do it, I can manage it as well’. I remember having a conversation with a male consultant about putting socks on at 35 weeks pregnant. I was having difficulties putting my socks on and he was like ‘yes, I have difficulties with that as well’ and it was a hilarious moment.“

“I think if you feel that things are getting compromised – either on your family side or on your job side then you have to reconsider. Work less and spend more time at home. Or the other way around – if you feel that you are missing out on things and progressions in your career then maybe you should organise more backup from home. In the end, everyone needs to be happy and stay happy – including yourself.”

“It’s a marathon rather than a sprint. It’s not glamorous on a day to day basis at all as it is portrayed on the TV. But it is doable and workable and if you are prepared to put in the hard work it is a very rewarding career to have.”

The Glass Cliff

“I didn’t have any medics in my family to get the stories so surgery is something you see on TV and they’re always depicting men in surgery and then the women who are struggling to be at the same level as them. And then as a student I’d come to the hospital and I’d have my placements and every time in general surgery I’d see these old school surgeons and the top ones were always male. I hardly saw any females.”

The quote above is taken from our last post on role models in surgery and illustrates an important point: While more and more women are entering medicine in general and surgery in particular, the higher echelons of surgery are still almost exclusively populated with men. This is of course by no means a problem for surgery alone. The same pattern can be observed almost everywhere from the corporate world to politics and there are a number of explanations for this phenomenon. One widely used metaphor is the Glass Ceiling which refers to the fact that women hit an invisible barrier which keeps them from progressing as they advance through the ranks. However, recent research shows that women face additional obstacles even if they manage to break through the Glass Ceiling – they might find themselves on a Glass Cliff.

This term, coined by Michelle Ryan and Alexander Haslam, describes the fact that women who break through the glass ceiling often find themselves in more precarious leadership positions where failure is more likely in comparison to their male colleagues. Evidence backing up this idea was first found when re-examining the fact that as the number of women on FTSE 100 company boards increased, the performance of these companies decreased. This had previously been interpreted as evidence for the lack of women’s leadership ability, but as it turned out, it was not the number of women that predicted company performance, but rather company performance that predicted the number of women. In other words, more women were appointed to company boards in times of crisis. This pattern was not found for men.

Since first discovered in 2005, the Glass Cliff has been studied in a variety of settings (e.g. politics) using a variety of samples (e.g. business leaders, students) and methods. If you are interested in reading more, here are links to some interesting articles about the Glass Cliff:

The article discussing the findings above (abstract)

Politics and the glass cliff (abstract)

The glass cliff as a result of stereotypes (abstract)

The glass cliff and suitability of men and women for leadership positions (full pdf)


More on Role Models in Surgery

As discussed in a previous post, role models for women need not necessarily be female to be inspirational to women. Here are some interesting quotes from men and women in surgery talking about female and male role models and who inspired them along their career path:

“Role models are really important but when I was trained there weren’t many women role models. The few women that had made it into surgery were really quite daunting characters and they weren’t necessarily inspirational. They were very committed to their jobs and they weren’t doing something I necessarily wanted to do, whereas there were an awful lot of men in surgery who were inspirational. They were very well balanced, they had a lot of interests, they were very intelligent, sensitive men – and they were role models at that time. And they were also the ones who were saying ‘look, there is no reason why you can’t do this’.”

“I think what you need is someone senior who takes you under their wings from a young age and says ‘we think that you can do this, we think you have the potential, we are interested in you as a neurosurgeon’. I had that in neurosurgery, so when I left my neurosurgical post to go to take up an ENT post they said ‘I don’t think you’re doing the right thing’ and they were right. And of course that is a huge influence. In fact, I think they had more influence than my parents did in terms of my future ultimate role. I didn’t have the opportunity to have female role models at this stage. There wasn’t another female neurosurgeon who I could ask about the practicality of running a life, having babies and being a neurosurgeon. But I had enough support from the male counterparts that I came across to know that wasn’t an insurmountable problem.”

“I have many female consultants in my department in Spain. I’m thinking of two of them because I really enjoy working with them. One of them is a breast surgeon and mother to two children and I’ve been operating with her during a long microsurgery with her pregnancy belly and it was really fun. She is really committed to her job and to her family. The other one is a lower limb surgeon and she performs the best surgeries I’ve seen. It’s a real pleasure to work with her.”

“I didn’t have any medics in my family to get the stories so surgery is something you see on TV and they’re always depicting men in surgery and then the women who are struggling to be at the same level as them. And then as a student I’d come to the hospital and I’d have my placements and every time in general surgery I’d see these old school surgeons and the top ones were always male. I hardly saw any females. My female role models came from elsewhere in medicine. Eventually I started reading about female surgeons out there. When I went to the Royal College of Surgeons to take my exams, there is this amazing mural on the wall in one of the rooms and it has all the female surgeons in the whole country who are eminent. And as cheesy as it sounds – I’d often look up to that mural in times when I just couldn’t revise anymore for my exams and I’d think ’one day I want my name to be up there’.”


The “Feminising” of Medicine

In this recent article, Alan Bleakley from the University of Plymouth discusses the ‘feminising’ of medicine as more and more women enter the field. He argues that this process needs to go beyond a change in demographic numbers and that women as well as men should use the higher number of women in medicine to reform the field and rid it of its patriarchal structures, practices and gendered ways of thinking (e.g. valuing quantity over quality of patient care in the case of limited resources). Theories drawn from post-structural feminism that focuses on the social construction of gender can serve as a guiding framework for such an endeavour. He suggests that by doing so the feminising of medicine will result in a facilitation of democratic habits in medicine and notes that changes in medical education are necessary to bring about this change.

It could be argued that surgery being one of the more ‘masculine’ fields of medicine, would benefit more than other fields from such a change. Or is it that the nature of the field makes certain stereotypically masculine practices and structures necessary? Is surgery already in the process of being more ‘feminised’ in ways that go beyond demographic changes?

We are interested in what you, as experts on this issue, think about it. Please feel free to let us know!