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16th February 2022

Are women more likely to die post-surgery under a male surgeon?

A terrifying and headline grabbing statistic has drawn plenty of media attention., but is there anything to the claims?
Are women more likely to die post-surgery under a male surgeon?
Photo: Uday Kumar @ Fshoq

A study has emerged in the JAMA Surgery medical journal suggesting a dramatic 15% increase in chance of a poor outcome in females treated by a male surgeon.

The study also found a 32% greater chance of death in female patients when operated on by male surgeons when compared to their female counterparts.

The research findings are based on 1.3 million surgical patients in Ontario, Canada over a period of more than ten years. The participants all underwent a range of common operations performed by nearly three thousand surgeons.

The observations from this study are undeniably very alarming. Questions about gender biases have long been directed at the surgical vocation. The inflexibility of surgical rotations in accommodating part-time work is seen as a common barrier for women progressing to the upper echelons of the profession, with 86% of the most senior surgeons (consultants) in the UK being male.

There is clearly a large proportional over-representation of male surgeons at the senior end of the specialty. More senior surgeons will generally take on more challenging operative procedures due to their experience. With more challenging surgeries generally producing worse outcomes, it is reasonable to attribute the gender imbalance in patient outcome in part to this structural feature of the profession.

Death following surgery is a rare event. However, this does not change the significance of the study. Despite the individual risk increase equating to only one extra death for every six hundred and twenty five surgeries performed, it is still crucial that any inequities in outcome based on the gender of the patient are addressed. 

Whether the revelations from this study can be explained away by differences in the structure of the profession is up for debate currently. Whatever the outcome of further scrutiny, it seems clear that more female surgeons in the profession can only be a benefit to patients.

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