title: Women in Surgery: Exploring Stakeholders' Lived Experiences in the Irish and Scottish Healthcare Systems
titleType: Other
Creators: name: Offiah, Gozie
Publisher: name: University of Dundee
Year: 2022

description: The healthcare workforce potentially faces substantial challenges if fewer women pursue surgery. It is evident that there are many women in the graduating classes from medicine, yet this is not represented at the higher levels in surgery. While some countries (e.g., UK) have seen an increase in female surgeons and consultant surgeons over the last decade, others (e.g., Ireland) have seen figures remain static. Worldwide, the number of women in surgery at the consultant level remains low compared to other specialities. While research has shown challenges and barriers for women in surgery, this study explores the perceptions of female surgeons and the colleagues and patients of female surgeons on the topic of women in surgery.

This research study is epistemologically grounded in social constructionism and focuses on how knowledge is constructed through social interactions. My research study involved a narrative inquiry from a methodological perspective adopting a storytelling approach to capture female surgeons’, colleagues’, and patients of female surgeons’ perceptions of gender in surgery; exploring how they make sense of their experiences and others and their conceptualisations of working in the NHS in Scotland or the HSE in Ireland. A qualitative research approach drawing on biographical narrative interpretive interviewing provides a comprehensive picture of the multiplicity of issues existing for female surgeons in the two countries. This approach was employed as it emphasises the socially constructed nature of reality and helps provide a rich and complex understanding of female surgeons’ issues. My sample included 29 female surgeons, 10 male and eight female colleagues (e.g., surgeons, nurses, physician associates, anaesthetists), and 6 male and 7 female patients. Framework analysis was used to identify initial key themes for coding the data. Narrative analysis was used to explore what and how participants narrated their stories.

The overarching themes derived from the data across all stakeholder groups indicated gendered surgical cultures, gendered surgical career transitions, and intersecting identities of surgeons. My findings showed that gendered surgical cultures played an essential role in shaping surgical careers and, in many cases, acted as a barrier to career progression, particularly for female surgeons. In addition, the data indicated that surgical cultures transcend country cultures outlined in Hofstede’s cultural dimensions. I identified the multiplicity of time-related and spatial transitions of doctors from medical school to surgical training and consultant positions and the influences of these transitions on work (e.g., careers) and home life (e.g., families). Finally, I uncovered how female (and male) surgeons' gender, age, ethnicity, and professional identities intersect to influence interactions in the surgical environment, especially for female surgeons.

Novel findings identified that gendered surgical cultures transcend country cultures and female surgeons are keen to overcome these surgical cultures to progress in surgery. Findings also identified multiple transitions at different stages of training impacting several domains. Finally, findings  identified intersecting identities of surgeons, including male surgeons and the influence of these intersections.

In conclusion, this study identified issues that could be addressed through enhancing educational policies and practice within surgical training on gendered challenges for women in surgery and to improve surgical cultures and transitions. It is hoped that the recommendations from this thesis will contribute to diversifying the healthcare workforce and addressing issues on gendered surgical cultures