Gender diversity in UK surgical specialties: a national observational study

Thomas Hedley Newman; Matthew G Parry; Roxanna Zakeri; Victoria Pegna; Amy Nagle; Farah Bhatti; Stella Vig; James Stephen Arthur Green

doi:10.1136/bmjopen-2021-055516

Gender diversity in UK surgical specialties: a national observational study

BMJ Open. 2022 Mar 21;12(2):e055516. doi: 10.1136/bmjopen-2021-055516.

Authors

Thomas Hedley Newman¹, Matthew G Parry², Roxanna Zakeri^{3

4}, Victoria Pegna^{5

6}, Amy Nagle⁷, Farah Bhatti^{6

8}, Stella Vig^{6

9}, James Stephen Arthur Green^{10

11}

Affiliations

¹ Department of Urology, Kings College Hospital, London, London, UK thomas.newman1@nhs.net.
² London School of Hygiene and Tropical Medicine Department of Health Services Research and Policy, London, London, UK.
³ Whittington Hospital, London, London, UK.
⁴ UCL Division of Medicine, London, London, UK.
⁵ Kent Surrey and Sussex Deanery, Crawley, West Sussex, UK.
⁶ Royal College of Surgeons of England, London, London, UK.
⁷ Urological Department, Barts Health NHS Trust, London, London, UK.
⁸ Cardiothoracic surgery, Morriston Hospital, Swansea, Wales, UK.
⁹ Department of Vascular and General Surgery, Croydon Health Services NHS Trust, Croydon, Greater London, UK.
¹⁰ Urology, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.
¹¹ Health Service and Population Research Department, Center for Implementation Science, King's College London, London, UK.

Abstract

Objectives: To compare gender diversity between UK surgical specialties, assess trends over time, and estimate when gender parity might be achieved.

Design: Observational study.

Setting: National Health Service, UK.

Participants: NHS Hospital & Community Health Service workforce statistics for 2011 to 2020 MAIN OUTCOME MEASURES: Logistic regression was used to compare female representation in 2020 between surgical specialties, and to examine for any significant trends between 2011 and 2020. The method of least squares was used to estimate when female representation of specialty registrars would reach 50% ('gender parity') for specialties with <40% female representation.

Results: In 2020, female consultant and specialty registrar representation was significantly different between surgical specialties (both p<0.001). Female representation for each specialty were as follows (from highest to lowest): Specialty Registrars-Ophthalmology 49.7%, Otolaryngology 48.2%, Paediatric Surgery 45.5%, Plastic Surgery 42.2%, General Surgery 39.8%, Urology 31.6%, Vascular Surgery 25.0%, Neurosurgery 24.7%, Cardiothoracic Surgery 21.3%, and Trauma and Orthopaedics 20.6%; Consultants-Ophthalmology 32.4%, Paediatric Surgery 31.7%, Plastic Surgery 20.9%, General Surgery 17.5%, Otolaryngology 17%, Vascular Surgery 13.7%, Urology 11.7%, Cardiothoracic Surgery 10.8%, Neurosurgery 8.2%, and Trauma and Orthopaedics 7.3%. There was a significant positive trend in female representation of specialty registrars between 2011 and 2020 for all specialties except for Paediatric Surgery (representation consistently >45%) and Vascular Surgery (representation consistently <30%). General Surgery was estimated to achieve gender parity of their specialty registrars by 2028, Urology by 2033, Neurosurgery by 2064, Trauma and Orthopaedics by 2070, and Cardiothoracic Surgery by 2082.

Conclusions: Despite improvements over the last decade, gender disparity persists in the UK surgical workforce and there are significant differences between surgical specialties. Further work is necessary to establish the reasons for these observed differences with a specific focus on Vascular Surgery, Cardiothoracic Surgery, Neurosurgery, and Trauma and Orthopaedics.

Keywords: human resource management; medical education & training; organisation of health services; surgery.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Child
Female
Humans
Internship and Residency*
Male
Orthopedics*
Otolaryngology*
Specialties, Surgical* / education
State Medicine
United Kingdom