Survey Reveals Alarming Rates of Sexual Assault Among Female NHS Surgeons
Roughly 30 per cent of female surgeons in the NHS have experienced sexual assault within the last five years, as revealed by a survey dubbed a "surgical #MeToo movement."
The study, disclosed in the British Journal of Surgery and made available to the BBC and the Times, includes reports of 11 cases of rape by participating surgeons.
According to the study's authors, there is currently a trend in NHS hospitals where senior male surgeons are abusing female trainees. The findings were described as "truly shocking" by the Royal College of Surgeons.
BBC News has been given exclusive access to an analysis conducted by researchers at the Universities of Exeter and Surrey and the Working Party on Sexual Misconduct in Surgery.
Almost two-thirds of the women surgeons who participated in the study reported experiencing sexual harassment at work, and a third reported being the victim of sexual assault by a coworker within the past five years.
Women report low confidence in the NHS's ability to take action if they report an incident and a fear that doing so could harm their careers.
Judith, an interviewee, requested that BBC just her first name when referring to her. Though now a skilled and accomplished consultant surgeon, she recalled an incident in the operating room where a senior male surgeon was sweating.
"[He] just turned round and buried his head right into my breasts and I realized he was wiping his brow on me," she told BBC. "You just freeze right, 'why is his face in my cleavage?'"
When he did it for a second time Judith offered to get him a towel. The reply came back "no, this is much more fun", she says, "and it was the smirk - I felt dirty, I felt humiliated".
The complete lack of response from her coworkers was even more upsetting.
"He wasn't even the most senior person in the operating theatre, but he knew that behaviour was ok and that's just rotten."
Although this incident with Judith occurred during surgery, sexual harassment and abuse are a much wider problem.
Anne, whose identity the BBC did not disclose for legal reasons, approached the BBC because she thinks that change will only come about if people speak out.
Although she does not call what happened to her rape, it is evident that the sexual encounter was not voluntary. It took place at a social gathering associated with a medical conference, where specialists in the same field of medicine met.
She was an intern and he was a consultant, following a standard formula.
"I trusted him, I looked up to him," she explains.
He took advantage of her confidence by making it seem like she couldn't trust the other guests because she didn't know them.
"So, he walked me back to the place I was staying, I thought he wanted to talk and yet he just suddenly turned on me and he had sex with me."
She said that at that moment her body froze and she "couldn't stop him".
"It's not what I wanted, it had never been what I wanted, it was totally unexpected," she said. "I didn't feel I could make a fuss, I felt like there was a very strong culture of just putting up with whatever was done to you."
Initially, the incident rendered her emotionally numb; however, years later, "the memory would come flooding into my mind like a horror, like a nightmare" at work, even as she was preparing to operate on a patient.
The existence of a culture of silence regarding such conduct is widely acknowledged. Women surgeons have told BBC that it is dangerous to speak out against those in positions of authority because of the impact on their careers.
The report, which will appear in the British Journal of Surgery, represents the initial attempt to quantify the problem.
Registered surgeons - men and women - were invited to take part completely anonymously and 1,434 responded.
The majority of women (63%), were victims of sexual harassment at work. Thirty per cent of women had experienced sexual harassment or assault at work. Eleven per cent of women have experienced coerced physical contact in the workplace. As many as eleven rapes were reported. Some form of sexual misconduct was witnessed by 90% of women and 81% of men. However, the report concludes that male and female surgeons are "living different realities" although it shows that men are also victims of some of this behavior (24% had been sexually harassed).
"Our findings are likely to shake the confidence of the public in the surgical profession," said Dr. Christopher Begeny of the University of Exeter.
Over the course of five years, the NHS saw 35,000 cases of sexual misconduct. Doctors' workplaces are cracking down on sexual harassment. In the meantime, a second report, Breaking the Silence: Addressing Sexual Misconduct in Healthcare, details the problem and offers solutions.
According to both reports, the high-pressure environment of surgery is made worse by the fact that there are comparatively fewer women surgeons (around 28%) and that surgery is deeply hierarchical.
"That leads to people being able to behave with impunity and much of this goes unchecked," said Professor Carrie Newlands, a consultant surgeon at the University of Surrey.
After hearing the stories of her junior coworkers, she was inspired to do something about the problem.
The most common case involves a senior male perpetrator, often a supervisor, abusing a junior female trainee, she told the BBC.
To quote one author, "and that results in a culture of silence where people are in real fear of their future and their careers if they do speak up."
One recurring theme in the data was a lack of faith in the various organizations working on the issue, including NHS Trusts, the General Medical Council (which oversees the UK's list of licensed physicians), and the Royal Colleges (which represent various medical subspecialties).
Prof. Newlands argues that in order for healthcare to become a safer place to work, there needs to be a significant change in investigation processes so that they become external, independent, and trusted.
The results of the survey are "deeply shocking and will be a source of great embarrassment to the surgical profession," Tim Mitchell, president of the Royal College of Surgeons in England, told the BBC.
The fact that it is "clear it is a common problem" that has not been resolved was something he admitted as well.
He added, "We need to put in place a culture of zero tolerance to ensure that there are mechanisms that mean people who are affected feel confident that they can come forward, report these incidents, and they will be taken seriously."
NHS England's Dr. Binta Sultan called the report "incredibly difficult reading" and "clear evidence" of the need for more action to make hospitals "safe for all."
In a statement, she said, "We are already taking significant steps to do this, including through commitments to provide more support and clear reporting mechanisms to those who have suffered harassment or inappropriate behaviour."
Last month, the General Medical Council revised its requirements for physicians.
CEO Charlie Massey stated that "acting in a sexual way towards patients or colleagues is unacceptable" and that "serious misconduct is incompatible" with remaining in the medical profession in the United Kingdom.