Last year, the Royal College of Surgeons in Ireland set up a working group on Gender Diversity in Surgery. Professor John Hyland, president of RCSI, took to The Irish Times last week to give us an update. In an opinion piece titled We need more female consultant surgeons, he explains that his club doesn’t have enough women in it and something really must be done. He means well but his position reveals a projection of his own preferences onto the wider world.
The idea that we need to help women get into surgery implies first that being a surgeon is a good thing. For most people, it probably isn’t. Unsurprisingly, the head of RCSI thinks surgery is the best thing in the world. If he didn’t, he probably wouldn’t have ended up leading RCSI. Prof. James Lucey of St. Patrick’s Hospital thinks psychiatry is the greatest thing in the world. Perhaps we could arrange a white-collar boxing match to settle the issue.
Prof. Hyland writes:
“Female medical students tend to underestimate their own abilities, as women do in many other walks of life. Canadian prime minister Justin Trudeau, a pioneer of gender equality in politics, has famously remarked: “You ask a man, ‘Do you want to run for office?’ His first question is, ‘When do I start?’ You ask a woman, ‘Can you run for office?’ Her question is, ‘Really? Why me? Do you think I’m good enough? Are you sure?’”
Maybe Justin Trudeau really is a pioneer. Maybe he’s a deeply sexist white knight and an indication that we should distrust the judgement of the average Canadian. Maybe Trudeau can’t tell the difference between a female senator and his 8-year-old daughter.
Prof. Hyland suggests that “the same self-underestimation may well be leading female medical students and newly qualified doctors to opt out of even considering a career in surgery”. Again, that makes sense only if we first accept the premise that those who are confident in their own abilities should want to train as surgeons.
People who lack confidence in their own capacity don’t enter paediatrics at a ratio of three to one [US data]. Paediatrics is, after all, harder than normal medicine because you’re dealing with nearly every disease adults get along with innumerable weird metabolic syndromes that nobody’s ever heard of.
People who lack confidence in their own capacity don’t become the majority of consultant obstetricians, a career that is spent constantly surrounded by lawyers with a thirst for blood.
It seems that Prof. Hyland looks at some of the most capable people on the planet and sees a variety of unusually tall toddlers, lost without the help of a paternal authority to guide them along their true path.
People who find surgery exciting should want to train as surgeons. Not interesting, but exciting. The prospect of repairing tissue should make the potential surgeon spring out of bed at five the morning, brain dripping with dopamine.
Everyone in medicine has to understand the surgical basics. People in different specialties have to be able to talk to one another. GPs and non-surgeon hospital doctors pay attention when surgeons present their research. Specialists in emergency medicine have to be able to perform some surgical operations.
That isn’t the same as spending thousands of hours perfecting specific techniques. It isn’t the same as comparing outcomes in tens of thousands of operations to see if one approach confers a cost advantage over another. Maybe a person needs an unusual obsession to become a consultant surgeon and be cheerful about it.
I have no idea what causes that unusual obsession but it’s entirely possible that, wherever it comes from, it’s more likely to appear in men. Lots of things are more likely to appear in men, such as the proclivity to murder, interest in chess, antisocial personality disorder, and beards.
Prof. Hyland’s article ends in a predictable manner:
“Gender diversity is not just an issue in surgery. It’s not just an issue in healthcare. Gender diversity is an issue in all aspects of life, and in surgery we must begin the work needed to bring it about.”
That is a statement of patent nonsense. We must instead begin the work of convincing senior figures in all areas of life that their younger colleagues are not their property and are not assets to be invested and moved around like financial stocks or board game pieces.
If there is one thing people in the modern world absolutely do not need, regardless of their age, it is yet another parent figure. We are already surrounded by too many to count.