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BAME and female surgeons experience severe disadvantage in promotion

24th Sep 2021
BAME and female surgeons experience severe disadvantage in promotion

(Photo credit: Engin Akyurt/Pixabay)

Nadine Osman

Surgical doctors from ethnic minorities and women experience “significant disadvantages” as well as a “glass ceiling” when seeking top promotions, new research shows.

Despite having similar work histories as their male counterparts, female surgeons are consistently less likely to become consultants, the British Academy of Management heard on September 1.

Professor Carol Woodhams, of the University of Surrey Business School, Ira Parnerkar of Queen Mary University, and Mukunda Sharma of Exoduspoint Capital LLC, analysed data on 3,402 NHS junior surgeons in England from 2009 to 2010, studying how many had progressed to consultant level by 2020.

The raw data from the Electronic Staff Record for NHS staff showed that rates of promotion for women and BAME groups were lower than those for white men compared to the promotion rates to consultants from 2016 to 2020 of white men.

The statistics also showed that in 2010, 57 per cen of junior surgeons were men. By 2020, that had increased to 63 per cent men as more women than men had dropped out of the career structure, and the proportion of men promoted to consultant was 53.6 per cen, and for women 36.5 % .

Ethnic minority women comprised 15 per cent of surgeons in 2020 but only 8 per cent of trainees promoted to consultant were from this group.


Promotion probability by race and gender

 

Black women were 42% points less likely to be promoted.

Women of Indian/Pakistani ethnicity were 28 % points less likely to be promoted.

White women were 21 % points behind.

Asian Women were 14 % points behind.

Black men were 27 % points behind

Indian and Pakistani men were 10 percentage points behind.

Other Asian Men were 6 % points behind.


Professor Woodhams adjusted the raw data to compare surgeons who were of similar age and background and who had worked a similar number of hours in training.

Taking maternity leave of any length resulted in a 7 per cent decrease in chances of reaching consultant level by 2020, and taking any other type of career break, such as working part-time for childcare, resulted in an 8 per cent reduction in promotion chances.

Even when comparing groups with the same number of training hours and same record of career interruptions, women and Black men were less likely to be promoted to consultant.

“The most striking finding is that even when Indian women, white women and Black men conform to white male patterns of working, the progression gap is wide and, in some cases, very wide,” Professor Woodhams said.

“This is objective evidence that disadvantage against diverse groups in surgery is deep-rooted and a new progressive milieu in the NHS and the broader society has not yet translated into concrete and progressive outcomes.

“Women, and especially non-white women, are under-represented in senior ranks of consultant, making a prima facie case for the existence of a glass ceiling.

“Black male surgeons are severely disadvantaged. Black males work long hours, take very few part-time or career interruptions, and tend to work in most elite subspecialties of surgery. Yet they are one of the least likely to secure promotion.”

Non-white trainees were less likely to be promoted to consultant in hospitals where there was a high proportion of white men, she said.

Part of the reason for the high promotion rate of white men may be an old-boys’ network, she said. “Women and ethnic minority junior surgeons may have less access to important informal networks that bestow the sponsorship and patronage that is so important in securing a consultant post.”

She said that her research quantified the effects of previous surveys in which a third of trainee surgeons said they had experienced bullying, undermining and harassment from, in most cases, a consultant.

“In an elite profession, surgery is arguably the most elite of specialities. It is competitive, pressurised and receives the highest reward, but it is consistently associated with a bullying culture that is especially hostile to women.”
Professor Woodhams told The Muslim News she recommends NHS trusts embrace, “The direction set by the Royal College of Surgeons in their 2021 strategy to ‘Change the Face’ of surgery to challenge discrimination and set a culture of collaboration, respect and excellence.”

As well as increase “the provision of NHS nurseries and other support for childcare to accommodate out-of-hours and shift working and implementing better retention, re-entering and retraining policies to retain women. Begin with a review of the hurdles that exist and then work to eliminate them.”

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