I was determined to be a surgeon after finishing medical school. I carefully picked my first jobs to put me on the path toward a lifelong surgical career. On the wards I was keen to be the best and brightest young surgeon, dedicating time to going to theatre, and taking on extra projects. In my first year I won the Welsh Surgeons junior gold medal prize for research I had nervously presented at a large conference. I was elated.
But, when I got home from that conference, I kept hearing comments familiar to every woman working in surgery: “Women can’t be surgeons, they aren’t strong enough, you won’t survive, how are you going to have kids?” It starts from the minute you consider stepping into surgery until the day of retirement. There were other behaviours, too – the small gifts left by colleagues every week, the invitations for coffee late at night, the comments on my appearance, and the not so funny sexualised banter.
It all gnawed at my self-worth, but I was determined to press on. The situation worsened, however. At a conference, a senior consultant sexually assaulted me at the bar. I froze, feeling the creeping hand on my body, and hurriedly made my excuses to leave. And yet I carried on pursuing my career, receiving a prestigious training job and moving across the country for a new start. But when I arrived, I was dismayed to hear the same comments, the same depraved behaviours again. I couldn’t escape and had to leave. The day I handed in my notice, I felt both relief and an acute sense of loss. I was no longer going to be a surgeon.
My story is familiar to many women in surgery, often not spoken about and hidden away in the back of our minds. The independent Working Party on Sexual Misconduct in Surgery (WPSMS) report out this week is a landmark in making our experiences visible. Nearly two thirds of female surgeons reported being sexually harassed by colleagues, and nearly a third reported being sexually assaulted by a colleague within the last five years. The numbers are staggering but not surprising. In an environment of such virulent institutional misogyny, women are unable to work and feel safe.
After my own experience, I spent years trying to raise awareness of the issues I faced. With Dr Chelcie Jewitt I founded Surviving in Scrubs, a website where people who work in any aspect of healthcare can anonymously share their stories of sexism and sexual violence from colleagues. The stories are numerous, and amplify the voices of those who could not otherwise speak out. We have received reports from female surgeons illustrating the impact behind the statistics, with survivors struggling to raise concerns, and being gaslit and blamed.
The WPSMS report is just one step on the long journey to stopping sexism and sexual misconduct in healthcare. The report focuses on staff working in surgery, but we must recognise that this is a cross-healthcare problem. Nursing staff and allied health professional all experience this issue, and it affects students as well as qualified professionals. At a time when the healthcare workforce is consistently in crisis, sexual misconduct is another load to bear.
To tackle this problem we must see engagement from every healthcare institution, including trusts, integrated care boards, universities, royal colleges and healthcare regulators. Recently there has been a lot of press about new charters on sexual misconduct, and updates to the General Medical Council’s “good medical practice”, and while this indicates recognition of the problem, action has yet to materialise.
Healthcare is one of the last sectors to recognise sexual violence within its ranks – a poor record for an NHS that should be focused on safety for staff as well as patients. Beyond the healthcare institutions, we must question if this is a problem for government to solve. Little has been seen or heard so far from the health secretary, Steve Barclay, or the Department of Health and Social Care.
One answer is that this problem is everyone’s to tackle, reflecting the injustices women face in wider society; but within healthcare, the responsibility must be on institutions and employers to take action. Through our campaign we have recommended a multitude of actions that seek to instil cultural change, including education, policy, reporting systems, reform of regulators and specialist support services.
It may be painful to recognise the extent of the issue, but surgery and the wider field of healthcare must get its house in order. As for my fellow survivors and me, the WPSMS report gives a sense of validation of the experiences we have had, and we now await the next steps.
Becky Cox is a specialist in gynaecology and pelvic pain, and the co-founder of Surviving in Scrubs
Information and support for anyone affected by rape or sexual abuse issues is available from the following organisations. In the UK, Rape Crisis offers support on 0808 500 2222 in England and Wales, 0808 801 0302 in Scotland, or 0800 0246 991 in Northern Ireland. In the US, Rainn offers support on 800-656-4673. In Australia, support is available at 1800Respect (1800 737 732). Other international helplines can be found at ibiblio.org/rcip/internl.html
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