Progress for women in surgery is at risk of stalling, as new data analysis reveals a growing gender gap in applications to surgical specialty training and a drop in the number of women accepted into fields like Trauma and Orthopaedics (T&O).
Official NHS data on the number of men and women applying for surgical training posts shows that women are proportionately more likely to be accepted onto surgical training programmes, and more women than ever are applying. In 2021, women secured almost 37% of surgical training posts, rising to 40% in 2024.
However, the ratio of male to female applications to surgical training posts has increased from just over 1.71:1 in 2021 to 1.95:1 in 2024, despite women outnumbering men in UK medical schools. Some specialities, including T&O, are becoming more male-dominated. Application rates for this specialty remained consistent between 2021 and 2024, with roughly five men for every one woman who applied each year. Despite this, the ratio of males to females accepted to T&O training programmes increased from 2.41:1 in 2021, to 4.93:1 three years later.
In addition, there is emerging evidence that women are less likely to experience opportunities to operate on patients. This is despite evidence that women have better operative outcomes than men.
While the cause is unclear, contributing factors may include an increase in applications by international medical graduates and men making a larger number of applications per applicant than women. Last week, the NHS announced changes to limit application numbers to five per applicant.
Women remain significantly underrepresented in surgery. On average, for every female consultant surgeon, there are currently five male consultants. No surgical specialty has more than 29% female consultants; in some, such as T&O, the figure is below 9%. Speaking recently at the Women in Surgery’s ‘Women at the Cutting Edge’ conference in Birmingham, Professor Felicity Meyer, Consultant Vascular Surgeon and Chair of the Women in Surgery (WinS) Forum at RCS England, says that while the data “tells an important story of progress, even if slow”, it also “highlights major risks to progress”. She will warn that the government risks stalling progress if forthcoming workforce and training plans do not support women in the profession.
Professor Meyer also highlights the ongoing barriers facing women in the profession, from early perceptions about the culture and compatibility with personal life, to the practical challenges of flexibility, visibility, and career progression. She warns that “to retain the very best surgeons, for future of the profession and for the future of the NHS, surgery must be a career that welcomes, supports, and sustains everyone who chooses it.”
RCS England is calling for the government’s upcoming 10 Year Workforce Plan and NHS England’s Medical Training Review to be designed with flexibility and work-life balance at their core. This includes encouraging NHS trusts to enable genuine flexible working.
Source: Royal College of Surgeons of England
Image: Canva
