10 Scientific American, April 2020
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Illustration by Lily PadulaChethan Sathya is a pediatric surgeon and journalist based
in New York City. Follow him on Twitter @drchethansathyaAs a male surgeon, I am mortified that the profession allows
my female colleagues to be treated like second-class citizens.
I have watched women surgeons get bullied, harassed and dis-
criminated against by their male counterparts. I have seen a
countless number of their careers crumble in front of my eyes.
I have seen their tears. I have seen them go into a deep hole
of depression and never come back. And I’m embarrassed to
say that for a long time, I did nothing about it.
New research is shining light onto the pervasiveness of sex-
ual harassment, intimidation and prejudice in our world of sur-
gery—but this is something that doctors have known about for
decades. It is deeply ingrained in our culture of medicine—and
it needs to change. While the rest of the world seems to be
embracing the #MeToo movement, we are running from it. As a
result, most cases of abuse are going unaddressed. And this is
leading to burnout and suicidal thoughts among surgeons.
It’s also bad for patients. When a person places one’s life
in the hands of a surgeon, one assumes that she or he is sin-
gularly focused on the patient’s well-being. But how can sur-
geons perform at their best if they are battling workplace abuse?
Like many male surgeons, I have been afraid to speak up out
of fear that it would destroy my reputation among senior sur-
geons in power, who are more often than not men. I am not
alone. “Men are bystanders. They know something is wrong.
They know someone is taking advantage of the situation. But
medical training is hierarchical, and most men find it hard to
challenge someone with more authority,” says Zeno Franco,
associate professor at the Medical College of Wisconsin. And
frankly, many male surgeons don’t care enough to do so.
A study in the New England Journal of Medicine shows that
about a third of surgical trainees in the U.S. experience gender
discrimination or verbal and physical abuse. Nearly two thirds
of female surgeons-in-training experience gender discrimina-
tion, and one in five is sexually harassed—often by senior super-
vising surgeons. Another survey showed that 58 percent of U.S.
women surgeons experienced sexual harassment within the last
year, and many incidents were not reported. The most common
reason: “fear of a negative impact on my career.”
Discrimination and abuse are daily occurrences for many
women surgeons; the perpetrators include co-workers, patients
and their families, and nurses, says Arghavan Salles, scholar
in residence at the Stanford University School of Medicine.
“This is an epidemic,” she says. “Not just one bad actor.” Because
women are scarce in academic surgery, says Karyn Butler, a pro-
fessor of surgery at the Sidney Kimmel Medical College of
Thomas Jefferson University, “they are the minority trying to
convince the majority. And getting ahead is based on reputation
among colleagues, making it easy for one’s career to be de -
stroyed for speaking out. To avoid sexual harassment at work,
she notes, many women surgeons have resorted to demeaning
ground rules, like “always wear a shirt under your scrubs, or else
male surgeons will look down at your chest.”
Men must acknowledge that discrimination and harass-
ment in surgery are a problem, Butler says, and they need to
step up. When we witness gender abuse, we need to support the
victim and call out our colleagues or make sure that leadership
is doing something about it. When we see great ideas from
women surgeons being discounted or undeservingly credited
to men, we can redirect the conversation. We can implore our
institutions to hire and promote equitably. We can demand
that they acknowledge maternity rights.
I myself have started raising these issues with my male col-
leagues. Some think the problem is overblown, and a few are
outraged. But I’ve been gratified to see that many are support-
ive of these efforts. We have had a number of conversations
around the topic, and most have been highly productive, with
women feeling comfortable sharing their stories of abuse. I urge
surgeons at other institutions to begin talking as well. They may
fear that their careers could be at risk, but our female colleagues
wouldn’t hesitate to stick their necks out for us. Let’s show them
that they are not alone.JOIN THE CONVERSATION ONLINE
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or send a letter to the editor: [email protected]Stand Up for
Female Surgeons
Their male colleagues are abusive, and
we must all be part of the solution
By Chethan Sathya
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