2023 | Volume 24 | Issue 2

The many firsts in surgery

Rhea Liang 1

Author: Associate Professor Rhea Liang


‘You can’t be what you can’t see’ is a common aphorism supporting visible role modelling in the workplace. It is at least partially true.

A study by Neumayer in 2002 showed that 88 per cent of women in a large US training scheme came from just three medical schools where women comprised a ‘critical mass’ of more than 40 percent of faculty.(1) However, it is only partially true, because someone has to be the first person, regardless of never seeing anyone they could identify with.

I have been inspired by so many other people being ‘the first’ during my surgical career. I have seen the first RACS woman president, Professor Anne Kolbe; I have seen the first Australian to win a Nobel Peace Prize, Dr Ruth Mitchell; and we are about to see the first Asian-origin RACS vice-president, Professor Owen Ung. These ‘firsts’ are undoubtably celebrated by the everyone in the surgical community, but they have a particular meaning to those who may not otherwise ‘see’ themselves as surgeons.

I did not always see myself as a surgeon. I had some ability in it—being a viva candidate for the surgical medal in my graduating year, which I did not win. But I had absorbed the many cautions about surgery been a difficult training pathway for women and had decided that general practice was a better fit for my aims. It is only through the consistent encouragement of surgical colleagues and more than a few serendipitous life events that I ended up as a consultant surgeon despite doing it all ‘wrong’—no higher degree, two babies, and a year off backpacking around the world.

We need to make the pathway into surgery less serendipitous. We need to make it a routine experience that potential surgeons of every gender, culture, orientation, and class feel valued in surgical workplaces. We need to rid our profession of the discrimination and harassment that still disproportionately affect specific under-represented groups.(2) We need to create surgical ‘homes’ for everyone—whether it be the breastfeeding rooms at conferences, or programs to support Indigenous Trainees, or marching at Sydney WorldPride.

Rhea Liang 2

I know there are some surgeons who feel the many diversity initiatives of RACS and Royal College of Surgeons England (RCSEng) leave less room for those from the ‘traditional’ stereotype. Professor Averil Mansfield, who became the first woman professor of surgery in the UK in 1993, has a particularly gracious way of thinking about this. When asked at the RCSEng International Women’s Day event about her experiences, she said, “I didn’t experience discrimination—it was just that people needed to get used to the idea [of a woman surgeon]”. 

Our ever-burgeoning waitlists are a sobering indication of how much the entire workforce will still be needed for the foreseeable future. ‘Getting used to’ more diversity doesn’t push anyone out—it makes the whole house larger and better able to meet the needs of a diverse community.

I have only been able to be a surgeon and do the work I have done with the support and inspiration of many others, including many who would identify with a ‘traditional’ surgical stereotype. I am entirely humbled to receive honorary fellowship of RCSEng, and I hope it will encourage others to ‘be what they can’t see’.


More: https://onlinelibrary.wiley.com/doi/full/10.1111/ans.18437


1. Neumayer, L, Kaiser, S, Anderson, K, Barney, L, Curet, M, Jacobs, D, Lynch, T & Gazak, C (2002). Perceptions of women medical students and their influence on career choice. Am J Surg, 183(2);146-50. doi: 10.1016/S0002- 9610(01)00863-7

2. Thread Consulting (2021). Building Respect, Improving Patient Safety Action Plan: Phase 2 Evaluation Final Report. https://www.surgeons. org/-/media/Project/RACS/surgeons-org/files/ BR-Eval-Report-FINAL-2021-11-03.pdf

3. Video available at https://youtu.be/W1jxFSmuLOs