I’ve thought long and hard about that title. Mostly because I ‘became’ a surgeon – the female bit happened well before I made any actual decisions in life. But I stuck with it because the path to surgery is a little different for women, as most already know..
When I told my mum that I wanted to do surgery, she smiled and said ‘you always do things the hard way’. And she has a point – her sentiment has been, and continues to be recounted to me, most sadly by female medical students.
“It's too hard.”
There are so many reasons we (you, me, society at large) come up with as to why not. Some of the most common are ‘too many exams’, ‘it takes too long’, ‘the hours are awful’. Your closer friends or more opinionated acquaintances will reason ‘you’ll never meet anyone’ and ‘I thought you wanted to have a family?’ or even ‘you know you’d make heaps more money as a dentist, right?’
Where do I even start? Yes, there are a lot of exams (heaps, actually, and they are really hard). Yes, it takes a long time – I started as an intern in 2007, began training in Otolaryngology and Head and Neck Surgery in 2009, and finally passed my last set of exams in 2013. Add in 4 years of post graduate medical school before that and, well, you get the picture – and looks much more rosy for dentists. The truth is, at medical school, and even as an intern, I had no interest in surgery. Zero. For all the reasons above, and plenty more – until I told someone that and he told me I was wrong.
Yes, 'he'.
A male surgeon, as a matter of fact. And not just one, but several. They mentored me through my first term as a surgical intern, taught and encouraged me, made fun of me in theatre and let me make fun of them in return. At the end of my rotation, whilst I enjoyed the work, I still wasn’t sold on a surgeons life.
They shot down every excuse I came up with.
...‘but isn’t it a boys club?’ / ‘Not if people like you change it!’
...’I don’t think my hands are steady enough’ / ‘You don’t need good hands, you need good judgement’
...’what if I don’t want to work full time, and I want to spend time with my family’ / ‘that’s great actually, we don’t have to worry about you stealing all our referrals’
...’but what if I want to have kids’ / ‘have them. It's never a ‘good’ time, so just do it. No one can tell you not to.’
And so I was out of excuses, completely overwhelmed by the support of my bosses, and totally in love with the job. I applied to the training program, was accepted, and began life as a female surgical trainee.
Challenges for the Female Surgeon
There are lots of difficulties faced by surgeons, but there are some inherent to females. They fall into 2 categories – biological and social.
The only true biological difficulty that is unique to surgery is that the time you spend completing your training happens to coincide nicely with your biological window for having kids. And it's not something that’s easy to outsource, because, you know, XY and all that. People often ask me if I was discouraged from having children whilst in a training position – I can only recall one instance where that happened, and although that consultant didn’t exactly say ‘you had better not’, it was implied. Otherwise, in every rotation I completed, discussions around children and family were commonplace, and I found great solace in being surrounded by surgeons who went home each night to their families, spending weekends ferrying sport gear around and packing school bags.
Social Challenges for Surgical Diversity
I call this ‘social’ because the societal construct around surgery is truly the largest barrier for female surgeons. Born from an age where educated men were the sole gatekeepers of the medical profession – a lot has changed, but some things haven’t. I don’t know a female surgeon alive that hasn’t been mistaken for a nurse, or asked ‘who has the kids?’. I can tell you that my husband has never, ever, been asked this same question (unless I’m with him at the time of questioning). And the reason is that society still assumes that the mother is the primary caregiver in the majority of relationships, and the implications of this assumption extends wholly to us as female surgeons. When it comes to reconciling multiple roles, ‘mother’ for females tends to dominate, leaving confusion as to ‘how we do it all’ in its wake.
I needn’t give more examples nor discuss it further except to mention the following to anyone considering a career in surgery. There are loads of credible reasons you shouldn’t (e.g. a dislike of early morning ward rounds), but wanting to have a family and a fulfilling career isn’t one of them. As a mother and surgeon, I can confidently report that it is possible, but not easy. Hearteningly I see more examples of flexible workplaces and shared parental responsibility around me every day. All the other reasons as to ‘why not to become a surgeon’ are becoming less relevant as time moves on and society embraces technology, changing stereotypes and ultimately greater workplace diversity – both with the challenges and opportunities it brings.