#SpeakerSpotlight: Kathryn Chu

Even in today’s world, gender inequalities straddle a wide proportion of the health sector - from clinical delivery to research, policy making and administration. ‘Doctor’ in some places is still synonymous with a man in a white coat, the ‘lifesaver’ and ‘Nurse’, a woman in a more discreet caregiving role. Some of the most visible inequities exist in the surgical profession. Whether today’s trainee surgeons see their gender as a barrier to professional success or not, the statistics are a galling reminder of the imbalance that still exists in the profession. To reference a few countries from many, only 12.5% of UK surgeons are female[1], growing fractionally to 20% in the US, despite more than 50% of US medical students being female. In Nigeria, there are reportedly just 60 licensed female surgeons[2].

These figures start to dwindle further when considering female surgeons in positions of leadership. Just 1% of surgery department chairs in the US are female[3]. I spoke to one such female leader in surgery to find out whether the figures suggesting a ‘man’s world’ in surgical research and delivery matched up with her personal experience of the profession.

‘Surgery is very much a male dominated field unlike other disciples of medicine where the male to female split tends to be more equal’, explains Kathryn Chu, colorectal surgeon and a Professor of Global Surgery in the Department of Global Health at Stellenbosch University in South Africa. ‘In South Africa less than 20% of surgeons are female.’ Pinpointing the exact reason behind the gap is difficult as a range of factors make up a hostile environment for female surgeons and surgical researchers. Family and career dynamics contribute to time pressures and lack of workplace support for women makes it difficult to compete for positions of leadership. 

Yet the imbalance, as Kathryn explains, also exists in cultural perceptions of the role of women, more accurately, preconceived ideas of how a female surgeon should behave. ‘In the operating theatre there are life or death decisions to be made on a daily basis’ she explains. ‘As a result, surgeons raise their voices or even occasionally use swear words to get their point across.  If a male surgeon does this, people accept as how a surgeon is meant to be, or else appreciate the urgency of the situation. If a female surgeon behaves like this it is considered hysterical or a sign of incompetence.'

While this double standard exists, Kathryn’s advice to new female surgeons in the field is simply to be competent in your craft and not to lose sight of who you are. ‘Even today, women are held to a higher standard in order to be on an equal par with men, and as a woman you take that away by being excellent at what you do.  if a female surgeon is not performing technically, it’s attributed to being a woman as opposed to being just not that good at your craft.’ However, femininity, she advises, is not to be shrugged off in the profession but instead celebrated as a vital part of clinical care. ‘Women bring in softer skills to surgical practice. Patients by their nature need empathetic surgeons which women naturally offer…  do not let go of being a woman when competing in the world of surgery. Just be yourself and be excellent in the craft.’

Excellence, resilience and determination have been cornerstones to Kathryn’s career trajectory, allowing her to reach a leadership position as Vice President of Doctors without Borders (MSF), Southern Africa and a board member for One to One Africa. ‘Everyone in the surgical profession works hard and the culture is not to complain...female surgeons complaining about gender inequality in their practice can be construed as weak. In addition, most surgical practices are not set up to allow for maternity or family leave without colleagues having to work extra to cover.  So, if a woman asks for those, they are resented by their peers. We need systems in place to change these ideologies.’

Kathryn also advocates for more formal pathways to mentor women in global surgery to overcome these preconceptions, a vital part of the Women Leaders in Global Health (WLGH) mission in uniting emerging and established health professionals. ‘I would tell aspiring young women to find themselves a mentor who is not only who you want to become in the profession, but how to model your life in other areas. Surgery infiltrates your work life balance and it’s vital to have a mentor who can help you navigate this.’ Parental leave poses additional challenges for women who are ‘left behind’ on returning to work and lose credibility for patient referrals. Women are forced to choose between being ‘caregivers’ at home and ‘caregivers’ in the operating theatre when, in fact, systems like job sharing could grant them access to both.

Conferences like WLGH19 are working to bridge the gap in gender imbalances, provide mentorship for emerging health professionals and support systems advancing female leadership in the health sector.  Kathryn Chu will speak at WLGH on 9-10th November, held in Kigali, Rwanda and hosted by the University of Global Health Equity. To find out more about the conference, its speakers and agenda, visit www.wlghconferences.org

[1] Fitzgerald, Grace. “The Gender Pay Gap in Medicine.” Level Medicine, levelmedicine.org.au/resources/completed-fellowship-papers/gender-pay-gap/.

[2]Abolarinwa AA, Osuoji RI. WOMEN IN SURGERY - an overview of the evolving trends in Nigeria. J West Afr Coll Surg. 2017;7(4):1–17

[3] Almendrala, Anna. “The More Women In The Operating Room, The Better For Doctors And Patients.” HuffPost, HuffPost, 12 Oct. 2017, www.huffpost.com/entry/more-evidence-that-female-surgeons-have-what-it-takes_n_59dd4fd1e4b01df09b7716d2.

Laura Wotton