News stories about sexual harassment in the workplace are not new and no workplace appears immune including within the health profession. Female surgeons have reported that sexual abuse, including in the operating room, is commonplace.
A report by the University of Exeter, University of Surrey and the Working Party of Sexual Misconduct in Surgery has sought to assess the scale of abuse that has reportedly been an open secret in surgery. A 2021 report on Sexism in Medicine and an article in The Lancet in February 2022 has already identified the concerns which the Working Party report confirmed in more detail some 19 months later. This is not a UK specific issue with a 2015 report from the Royal Australasian College of Surgery and the US 2020 residency survey raising similar concerns.
Female surgeons and male surgeons are “living different realities” according to the report. While some 24% of men reported being sexually harassed, 63% of women reported being the target of sexual harassment from colleagues with 30% having been sexually assaulted by a colleague.
An important and reoccurring theme with sexual harassment and assault in the workplace are the challenges in reporting the abuse. The hierarchical nature of the surgeon’s community fosters the silence of survivors. To progress in surgical careers there is a reliance on being in the good graces of senior surgeons, who are majority male. Female surgeons who have been harassed or assaulted consider they cannot speak out without risking the years of hard work they have put into surgery.
Dr Liz O’Riordan, former breast cancer surgeon, has spoken about how difficult it is as a junior to speak up because of how reliant you are on your supervisor. She says, “you are relying on them to let you cut, and if you call them out, they may say ‘I don’t like you, you are not coming into theatre today’."
Another repeating concern is distrust of bodies that are supposed to investigate allegations and reprimand perpetrators. Professor Newlands, Consultant Surgeon from the University of Surrey, said “we need a major change in investigation processes so they become external and independent and are trusted in order for healthcare to become a safer place to work”. A representative of the Royal College of Surgeons acknowledged to the BBC that it is “clear it is a common problem” that has not been addressed.
The General Medical Council has said they are adopting a zero-tolerance policy with new advice explaining that not just physical acts can be a breach. However, Surviving in Scrubs – a campaign group on sexism, harassment and sexual assault in healthcare – does not think the advice goes far enough. They call for cases to be thoroughly investigated rather than dismissed and appropriate sanctioning of perpetrators. Their 2023 report considers 150 accounts of sexual abuse in a medical setting.
After past workplace harassment scandals, it is surprising that we are still talking about a culture of silence and fear of the consequences of reporting along with ineffective investigations and sanctions by bodies designed to protect staff. Employers need to have robust and effective systems in place to react swiftly to reports of abuse and safeguard employees with preventative measures.