We are a group of committed NHS surgeons, clinicians and researchers who are working to raise awareness of sexual misconduct in Surgery, to bring about cultural and organisational change. This work is being carried out in collaboration with the University of Exeter (UoE) Psychology Department. Some group members are former targets, and some have been approached in the past for support by others. We all share a strong sense that many simply do not know where to turn. Group members and advisors can be found here.
Sexual misconduct happens. It is not new. There have recently been several powerful stories shared in the medical literature and in the wider media by colleagues who have been significantly impacted by this issue. Raising concerns is often difficult - reporting perpetrators of sexual misconduct who may be in positions of power is even more so. Definitions relating to sexual misconduct can be found here.
Sexual misconduct is a significant patient safety issue for several reasons.
1) We are aware that many trainees have been assaulted by their trainer, while operating on an anaesthetised patient. This is abhorrent and dangerous
2) Evidence shows that patients under the care of a dysfunctional team, where there is a lack of psychological safety, have poorer outcomes, with higher complication and death rates
3) Doctors who are harrassed, assaulted or raped by a colleague often develop depression and burnout, and are less able to care for their patients.
In 2022 we produced a survey in conjunction with UoE which gained ethical approval from UoE and the Health Research Authority. This was circulated from September 2022 to members of the professions providing the surgical workforce in the UK and Ireland, to benchmark what is happening. We asked what has happened to individuals, and importantly, how incidents were dealt with by impacted people, and finding out what responses they received if they raised concerns. Data from the survey will be presented and published by the Working Party and shared with stakeholders to inform us all how to bring about change. It is important that we hear all voices, including those who have never witnessed or experienced sexual misconduct.We also want to know about those survivors who have left a career in surgery, as a result of experiencing or witnessing sexual misconduct.
Our work in 2022 has been presented at the UK Institute of Medical Ethics Conference, the WIMIN Conference and the Birkbeck Sexism in Medicine Conference, as well as at the national conferences of the British Association of Oral and Maxillofacial Surgeons and the British Orthopaedic Association. We have also presented and discussed our work in association with the Claire Light, Head of Equality and Diversity for the GMC and the team from Surviving in Scrubs at the RCS England Future Surgery Show 2022.
The survey and our work have support so far from The Royal College of Surgeons (RCS) of England, The Royal College of Physicians and Surgeons of Glasgow (RCPSG), NHS England Safeguarding, the British Orthopaedic Trainees Association, The Association of Surgeons in Training and the Society of Women in Maxillofacial Surgery as well as the British Hip Society and the Royal College of Anaesthetists. We are also seeking guidance from and collaborating with other Surgical Royal Colleges, NHS Employers, the Association of Peri-operative Practiioners and the General Medical Council. We have also contacted the Royal College of Nursing.
We want surgery to be a safe place to work. We want to encourage inclusivity and diversity, so that those who want to be surgeons or to work within theatres, see surgery as a welcoming place. We want colleagues not to leave a career in the surgical workforce because they have been subject to sexual assault. We want a safe reporting system where impacted people can speak up without fear of personal detriment. We want robust mechanisms put in place by those with the power to sort this out, to ensure that perpetrators’ behaviours cannot continue, and that justice prevails for those who have been silenced or damaged.
We hope this work will help to continue the conversation, and that it will bring about change to ensure surgery is a safer place to work for all members of the surgical team, and ultimately a safer place for the patients who we are all privileged to look after.
What next?
Our survey has now completed and has been accepted for peer reviewed publication. A meeting at the GMC on 2 May 2023, arranged by WPSMS to present our data was attended by the GMC, the BMA, Surgical Royal Colleges RCOA, NHSE , NHS Employers, and Medical Educators and Surviving in Scrubs. We looked at challenges and solutions with those who have the power to make change happen.
A report is being prepared detailing our work, and includes outcomes of this round table meeting. This report will be published simultaneously with the release of our academic paper:
"Sexual Harassment, Sexual Assault and Rape by Colleagues in the Surgical Workforce and how Women and Men are Living Different Realities: An Observational Study using NHS Population-derived Weights"
Recipients of the report include:We are not able to act on individual reports or take forwards concerns raised about a perpetrator at present.
We are in contact with and supportive of the work of our colleagues Becky Cox and Chelcie Jewitt, who have set up Surviving in Scrubs, where anonymised stories can be told. Please tell them here. Surviving in Scrubs
Sources of support or advice are available here.
Further reading including the 2022 statement from RCS England and WinS is available here.
Terms of Reference Working Party on Sexual Misconduct in Surgery (WPSMS).
The aim of the WPSMS is provide information and to raise awareness about sexual misconduct in the surgical workplace (SMS).
The Working Party is an independent body.
The membership is drawn from members of the surgical workforce, together with other relevant experts and advisers.
Ethical support is provided by UOE.
Academic support is provided by UOE and group members and advisers.
Meetings will be held as required plan our priorities. Priorities include communication with stakeholders, engaging with the workforce, and producing data to support required changes.
Meetings will be:
Our website will be updated regularly to reflect our support, membership and progress.