2023 | Volume 24 | Issue 3

Gender equity

RACS has refreshed its gender equity targets to help increase the strength and diversity of our profession over the next five years, by boosting the number of women in surgery. 

In 2017, we set dual goals for gender equity: 
increasing the selection of women into surgical training to 40 per cent in 2021 
increasing the participation of women on RACS major committees and in leadership roles to 40 per cent by 2020. 

While we’ve made incremental improvements since 2016—collectively, we have not reached our goals.

Applications from women to SET training across all specialties increased from 30 per cent in 2016 to 32 per cent in 2022. Acceptance of women into surgical training increased from 25 per cent in 2016 to 31per cent in 2022. However, there is wide variation in gender representation between specialties and in the representation of women in leadership roles. 

Specialty-specific analysis of 2022 recruitment data shows that five specialties selected an equal or higher number of female applicants, and eight specialties selected fewer. More than 40 per cent of applicants in four specialties were women, but in two, the selection rate was lower than the application rate. 

Analysis of aggregated data showed 39 per cent of college councillors were women against a 40 per cent target. Outside the major committees, our progress towards this target has been variable.

“The gender imbalance in surgery is explicable historically, but indefensible in 2023. We want to do better, and we have to do better,” said Dr Sally Langley, immediate past president of RACS. 

“Increasing women’s participation in surgery will enrich our profession, diversify teams, strengthen decision making and improve patient safety,” she said. 

The updated 2027 RACS gender equity targets introduce a 40:40:20 gender concentration and this applies across our two existing areas of focus—more female SET Trainees and more women in RACS leadership roles. This includes RACS Council, RACS major committees, and in leadership roles across RACS.

By 2027, we would like to see to see 40 per cent of Trainees selected to be women, 40 per cent to be men, and 20 per cent to be any gender. The same targets apply to the representation of women in College leadership roles. This target takes into consideration that there are fewer women available for appointment to College roles, a situation likely to continue for the foreseeable future.

These targets are compatible with the 50 per cent selection target proposed by Women In Surgery, by capping the total selection at 60 per cent for either men or women. 

RACS is encouraging the adoption of specialty-specific targets, to help the College community reach profession-wide targets. Progress will be monitored through annual reporting, including on actions taken to change the gender status quo.

The refreshed targets match the recommendations of the Building Respect, Improving Patient Safety 2022 EAG Report, which set the goal of fostering ‘cultural safety and diversity, striving for gender equity’, and included six explicit recommendations to help achieve this. 

Actions to help the surgical community meet the 2027 gender equity targets are set out in the RACS 2022 Building Respect Action Plan and the Women in Surgery Strategic Plan, and will be strengthened by discussions with specialty training boards. Guiding principles have been outlined, to help ensure the proportion of women applying to SET is reflected in the proportion of women selected. Transparent reporting on selection data and progress between specialties will enable nuanced comparison and identification of good practice.

“Through selection to SET, specialty societies and speciality training boards hold the keys to increased gender equity in surgery,” Dr Langley said.

“I am heartened that recent meetings with speciality societies have cemented our shared goal of enriching our profession, by enabling more women to contribute,” she added.

RACS introduced gender equity targets in 2017, under the RACS Diversity and Inclusion Plan, as part of our wider efforts to build a culture of respect in surgery.