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Isabella Busa, a medical student at the University of Oxford, shares her recently published article written with Dr Shobhana Nagraj as part of the Global Surgery Special Study Theme.

Female surgeon in blue PPE

According to the Lancet Commission on Global Surgery, 143 million additional surgical procedures are required each year to address unmet need in low and middle income countries (LMICs). Expanding the participation of women in surgery represents a crucial and logical way to alleviate this global surgical burden, as it is currently reported that there are only three female surgeons for every one million people in these countries. 

In our commentary article we discuss the underrepresentation of women in LMIC surgical workforces, arguing that the issue if self-reinforcing. While on the one hand, change requires sufficient numbers of female surgeons to initiate it, on the other, women can only start to enter the surgical workforce once they are safe, healthy, and motivated enough to do so. This in turn depends on the presence of female surgeons to advocate for their female patients and empower future generations of young girls. 

We address the barriers that prevent women from pursuing a surgical career and discuss how these differ in LMICs. For example, where in high income countries gender biases and motherhood penalties can limit the career progression of female surgeons, traditional cultural attitudes to female education can be more obstructive in LMICs. 

We go on to explore the benefits of including women in surgical teams and criticise currently proposed solutions to the female underrepresentation in surgery as being irrelevant to the problems faced in LMICs. Rather than a ‘one-size-fits-all’ fix, the diversity of challenges faced by women in surgery globally calls for similarly varied solutions. 

This analysis may help inform how best to expand the participation of women in surgery and alleviate the wider global surgery burden. 

You can read our article in full in BMC Human Resources for Health

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