Unmasking Surgical Stereotypes
The field of surgery, often considered the peak of medical expertise, is undeniably a profession overshadowed by stereotypes. The Oxford University Press defines a stereotype as a ‘preconceived and oversimplified idea of the characteristics which typify a person’. While surgeons are commended for their expert skill and competence, they are perceived as detached and aloof. This stereotype negatively influences interactions between doctors and patients.
The ‘surgical personality’ is a stereotype widely held within society. While it highlights the surgeon’s meticulous nature, it simultaneously regards the surgeon as a faceless robot behind the scalpel, detached and desensitised from the patient.
This stereotype has been deep-rooted within medical professionals and the public for some time. Whilst many are attempting to eliminate the stigma of a callous surgeon, the rise of social media has given many the ability to dramatise this cliché. Stereotypes in media have existed for decades. A prominent example is the 1950s film series Doctor which featured the surgeon Lancelot Spratt, who evoked fear in his trainees as he marched through the hospital, embodying the traits of the stereotypical surgeon. Recently, ophthalmologist Dr Glaucomflecken has leveraged his extensive social media influence to emphasise stereotypes by posting exaggerated skits of stereotypical qualities about doctors. An example of a skit included an aggressive surgeon, overpowering a medical student. Whilst these clips may seem harmless, they perpetuate the surgical personality stereotype further.
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A study by the Brazilian General Medicine and Surgery Residence Programs highlighted this stereotype where residents were interviewed about their opinions of different medical specialities. The GP was recognised as a ‘sensitive and concerned doctor with a close relationship with the patient’, where 45% used the phrase ‘calm, tranquil, and balanced’. Contrastingly, the surgeon was described as ‘practical and objective’ by 40%, and 23% recognised surgeons as ‘omnipotent, arrogant, and domineering’. The general practitioner was called a ‘doctor with heart’, ‘interested in the patient, he likes him, he doesn’t do a consultation in 5 minutes, he is interested in the patient’s life.’ The surgeon was portrayed as a ‘decisive person, he has to be more prepared for quick decisions, to keep calm and have a cool head’. One can conclude that while both the general practitioner and surgeon were commended in their respective roles, there was a common perception of GPs being recognised for their dedication and interest in their patient, compared to the residents feeling that surgeons were more intrigued and focused on the specific case, rather than the interpersonal relationship with the patient. In comparison, an article published in 2014 delved deeper into the theory of surgeons being less emotional than physicians. To test this hypothesis, researchers analysed the facial portraits of doctors, where it has been proven the asymmetry in the face allows emotional information to be conveyed stronger on the left side. The results proved that regardless of their specialisation, surgeons did not depict a lack of emotion to their patients, debunking stereotypes. Hence, one could argue that these two investigations demonstrate that the view that surgeons are more emotionally hardened than other doctors lacks scientific evidence, emphasising that these opinions are stereotypes ingrained within people’s minds without substantial reasoning.
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The consequences of the pervasive nature of these stereotypes may lead to patients harbouring subconscious fears about surgeons, compromising the patient-doctor relationship, perhaps even before their first consultation. Such preconceived notions may result in patients approaching surgical interactions with hesitance, ultimately affecting their willingness to communicate with their doctor. Moreover, the impact of these stereotypes extends beyond patient experience, infiltrating the dynamics among healthcare professionals. Healthcare colleagues may internalise assumptions about how they should interact with surgeons, subconsciously adopting submissive behaviours; underscoring how stereotypes can detrimentally impact holistic care by creating a hierarchical hospital environment.
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From a medical student’s position, the BMC published research studying FY2 doctors’ opinions on the surgical stereotype. One doctor stated ‘I think the surgical stereotypes can be quite negative in terms of surgeons losing a lot of their medical knowledge, but when they train perhaps being kind of oafy, sometimes arrogant.’. Another claimed ‘I think if you’re not a bit pushy and self-confident then you won’t be good at surgery work’, reflecting how this stereotype has significant implications for those considering the discipline. Some may feel they are not ‘macho’ enough to embody the ‘surgical personality’, dissuading students from pursuing surgical specialities if they perceive the field to be dominated by personality traits that they do not identify with. This can result in a lack of diversity, creating a cycle where stereotypes remain unchallenged and continue to shape the healthcare scene. Another female junior doctor found ‘there’s a bit of a stereotype of surgeons being brash, and the whole environment being quite macho. To a certain extent, I’ve seen that to be true, and it would put me off’, highlighting the self-doubt female doctors feel in pursuing surgical placements due to the stereotypical masculine attributes that have been associated with surgeons. This leads to another key stereotype about surgeons- that they are predominately males.
When thinking of a surgeon, one may imagine a man, reinforcing the stark gender stereotypes leading to the perception that surgeons are usually men, discouraging females from the profession, further solidifying the gender gap in the surgical profession. A study in 1991 showed only 3% of consultant surgeons were women in the UK. As of 2023, this figure had risen to 16.3%. This inequality highlights the disparities in the ratio of male to female surgeons. Much research has been conducted into why women are less likely to uptake a surgical role, or similarly why women are more likely to leave their surgical post compared to men.
JAMA investigated the disparities in surgery and found that while 15% of males left their surgical training program, 25% of female residents decided to leave. Whilst researching the reasons behind this data, they discovered it was a multifaceted issue about the lack of female surgical role models and negative attitudes towards women in surgery. This is compounded by a study conducted in 2000 where 40% of 247 female medical students had rejected surgery due to ‘personal preference’. When pressed on this matter, results highlighted they viewed the surgical field as ‘unfavourable to them, largely because of a perception of male bias’. Additionally, in 2009, Nottingham Medical School conducted a survey where 59% of males and 68% of females claimed surgery was not a career-welcoming woman, due to a lack of role models. These alarming statistics signify the need for more appropriate female role models in surgery and a shift in the attitudes of medical students
In the UK, surgery is a male-dominated profession. Research published in the BMJ shows how people base their understanding of the skills required for success in a particular occupation based on the individuals represented working in that field. Therefore, in surgery, there must be an assumption that one must possess masculine traits like dominance and emotional toughness to succeed. Hence, the surgical profession is associated with a masculine image, hindering those who do not identify with these traits. The assumption that surgeons must embody macho characteristics can also negatively impact male trainees who do not identify with this image. The study illustrated how the men who believed that they did not measure up to the macho surgeon stereotype had been predicted an increased career disengagement and a higher desire to leave the profession later. Therefore, students may be dissuaded from pursuing surgical specialities if they perceive the field to be dominated by traits they do not resonate with.
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To summarise, it is clear there is a stereotype overshadowing the surgical profession. As the medical world is changing rapidly, outdated stereotypes must be adjusted to dispel the falsified image. Many movements have been introduced such as the #ILookLikeASurgeon campaign in 2015, which was tweeted nearly 40,000 times where surgeons posted photos of themselves inside and outside of the operating room to defy gender stereotypes, whilst also humanising the profession. More must be done to encourage women to pursue surgery such as introducing more representative role models to set an example and provide guidance to those thinking of doing surgery. Regarding the ‘macho’ stereotype, it is crucial medical institutions actively challenge and dismantle the ‘surgical personality’ stereotype by incorporating soft skill training to ensure students understand emotional intelligence, empathy and communication are key qualities for all specialities. Encouraging medical students to critically examine their own biases and assumptions will foster an environment which encourages inclusivity. By acknowledging and addressing surgical stereotypes, the medical community can enhance both patient care and professional collaboration, ultimately leading to a more inclusive and supportive healthcare environment.
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References:
https://psyche.co/ideas/the-idea-of-a-surgeons-personality-wont-fix-the-profession
https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-022-03765-1
https://www.rcseng.ac.uk/careers-in-surgery/women-in-surgery/statistics/
https://jamanetwork.com/journals/jamasurgery/fullarticle/2593310
https://pubmed.ncbi.nlm.nih.gov/11089452/
https://pubmed.ncbi.nlm.nih.gov/22902099/
https://journalofethics.ama-assn.org/article/evolving-surgeon-image/2018-05