ObjectiveSurgery remains an inherently male-dominated profession. The aim of this study was to survey women working within the discipline, to understand their current perceptions, providing insight into their practical day-to-day lives, supporting an action-oriented change.Design and settingThe link to a confidential, online survey was distributed through the Association of Surgeons of Great Britain and Ireland (ASGBI) social media platforms on Facebook and Twitter over a 2-week period in October 2017.ParticipantsWomen working in surgical specialties and actively responding to the link shared through the ASGBI social media platforms. No patients were involved in the study.Primary and secondary outcome measuresData were analysed through a mixed-methods approach. The quantitative data were analysed through descriptive statistics and qualitative analysis was undertaken using a constant comparative analysis of the participants’ comments, to identify salient patterns (themes).ResultsA total of 81 female participants replied (42% response rate based on the Facebook group members), with 88% (n=71) perceiving surgery as a male-dominated field. Over half had experienced discrimination (59%, n=47), while 22% (n=18) perceived a ‘glass ceiling’ in surgical training. Orthopaedics was reported as the most sexist surgical specialty by 53% (n=43). Accounts of gendered language in the workplace were reported by 59% (n=47), with 32% (n=25) of surveys participants having used it. Overall, a lack of formal mentorship, inflexibility towards part-time careers, gender stereotypes and poor work–life balance were the main perceived barriers for women in surgical careers.ConclusionThese findings highlight the implicit nature of the perceived discrimination that women report in their surgical careers. The ASGBI acknowledges these perceptual issues and relative implications as the first of many steps to create an action-oriented change by allowing all staff, regardless of gender, to reflect on their own behaviour, perceptions and the culture in which they work.

Understanding the biological mechanisms mediating the eating behaviour changes engendered by bariatric surgery may lead to the development of novel therapeutic strategies for people with obesity.

ObjectivesTo compare gender diversity between UK surgical specialties, assess trends over time, and estimate when gender parity might be achieved.DesignObservational study.SettingNational Health Service, UK.ParticipantsNHS Hospital & Community Health Service workforce statistics for 2011 to 2020Main outcome measuresLogistic regression was used to compare female representation in 2020 between surgical specialties, and to examine for any significant trends between 2011 and 2020. The method of least squares was used to estimate when female representation of specialty registrars would reach 50% (‘gender parity’) for specialties with <40% female representation.ResultsIn 2020, female consultant and specialty registrar representation was significantly different between surgical specialties (both p<0.001). Female representation for each specialty were as follows (from highest to lowest): Specialty Registrars—Ophthalmology 49.7%, Otolaryngology 48.2%, Paediatric Surgery 45.5%, Plastic Surgery 42.2%, General Surgery 39.8%, Urology 31.6%, Vascular Surgery 25.0%, Neurosurgery 24.7%, Cardiothoracic Surgery 21.3%, and Trauma and Orthopaedics 20.6%; Consultants—Ophthalmology 32.4%, Paediatric Surgery 31.7%, Plastic Surgery 20.9%, General Surgery 17.5%, Otolaryngology 17%, Vascular Surgery 13.7%, Urology 11.7%, Cardiothoracic Surgery 10.8%, Neurosurgery 8.2%, and Trauma and Orthopaedics 7.3%. There was a significant positive trend in female representation of specialty registrars between 2011 and 2020 for all specialties except for Paediatric Surgery (representation consistently >45%) and Vascular Surgery (representation consistently <30%). General Surgery was estimated to achieve gender parity of their specialty registrars by 2028, Urology by 2033, Neurosurgery by 2064, Trauma and Orthopaedics by 2070, and Cardiothoracic Surgery by 2082.ConclusionsDespite improvements over the last decade, gender disparity persists in the UK surgical workforce and there are significant differences between surgical specialties. Further work is necessary to establish the reasons for these observed differences with a specific focus on Vascular Surgery, Cardiothoracic Surgery, Neurosurgery, and Trauma and Orthopaedics.

Coronavirus Disease-2019 (COVID-19) has had a severe impact on all aspects of global healthcare delivery. This study aimed to investigate the nationwide impact of the pandemic on obesity management services in the UK in a questionnaire-based survey conducted of professionals involved in the delivery. A total of 168 clinicians took the survey; the majority of which maintained their usual clinical roles and were not redeployed except physicians and nurse specialists. Nearly all (97.8%) elective bariatric surgery was cancelled, 67.3% of units cancelled all multidisciplinary meeting activity, and the majority reduced clinics (69.6%). Most respondents anticipated that the services would recommence within 1–3 months. This study found that the COVID-19 pandemic has had a severe impact on the services involved in the management of patients suffering from severe, complex obesity in the UK