Sexual misconduct is rife among colleagues in the UK surgical workforce, with women disproportionately impacted and staff believing organisations are not doing enough to protect them.

‘Breaking the Silence: Addressing Sexual Misconduct in Healthcare’ reveals the extent of sexual misconduct by colleagues - including sexual harassment, sexual assault, and rape - within the UK surgical workforce in the last five years. It is the first time this research has been undertaken.

Professor Rosalind Searle of the UofG’s Adam Smith Business School was involved in the collaboration between the University of Exeter, the University of Surrey, and the Working Party on Sexual Misconduct in Surgery.

The in-depth study, which has been published in the British Journal of Surgery, analysed anonymous online survey responses from 1,434 participants (51.5% women) in the surgical workforce. The team found that two-thirds of women (63.3%) had been the target of sexual harassment from colleagues, along with almost a quarter of men (23.7%).

Participants reported instances of rape at work, as well as in other work-related contexts including teaching spaces, conferences, and after-work events with colleagues. At least 11 incidents of rape were reported in the study. Given the design of the study, this number does not account for individuals who had been raped more than once, and not all participants were included in this analysis, which authors say may mean it is an under-estimate of the total number of reported rapes.

Research found nearly a third of women (29.9%) had been sexually assaulted by a colleague, while the majority of participants (89.5% of women, 81% of men) say they have witnessed some form of sexual misconduct. Sexual coercion was common, with 10.9% of women having experienced forced physical contact linked to career opportunities.

The study also found there is a widespread lack of faith in accountable organisations’ adequacy to deal with sexual misconduct. These included NHS Trusts who have a duty to protect the workforce, the General Medical Council (GMC), the British Medical Association (BMA), Health Education England, and the Royal Colleges.

Lead author Dr Christopher T. Begeny from the University of Exeter said: “Our findings are likely to shake the confidence of the public in the surgical profession. Sexual misconduct frequently occurs in the surgical environment but appears to go unchecked due to a combination of a deeply hierarchical structure, as well as a gender and power imbalance. When it happens among colleagues, sexual misconduct often goes unreported because of a fear of potential repercussions and damage to career progression. But these are illegal and criminal acts, and these findings require action.”

The study’s senior author Professor Carrie Newlands from the University of Surrey’s School of Medicine and a Consultant Surgeon said: “Cultural change in healthcare and particularly in surgery is long overdue. It is vital that regulators, colleges, employers, and training authorities come together to take a zero-tolerance approach to sexual misconduct and create adequate mechanisms with consequences to deal with perpetrators. This is why we are calling for major reform of reporting and investigation processes of sexual misconduct in healthcare, which need to be expert, independent, and fit for purpose. The current system simply isn’t working, and the workforce has justifiably lost faith.”

Co-author Professor Rosalind Searle said: “This research is long overdue. It clearly shows that it is essential that timely action is taken to restore trust at multiple levels for those in surgery. Ultimately, you can choose to either be part of the solution - or be part of the problem.”

Data from this study was presented at a meeting to representatives from the NHS, regulators including the GMC, training authorities, Royal Colleges, and the BMA earlier this year, where stakeholders discussed required actions. The outcomes of this meeting are included in the Working Party on Sexual Misconduct in Surgery report, “Breaking the Silence: Addressing Sexual Misconduct in Healthcare”. This report makes a series of recommendations to tackle the problem of sexual misconduct in healthcare, including the key recommendation of bringing in an external national body to help with progress.

Mr Tim Mitchell, President of the Royal College of Surgeons of England, said: “The findings of this survey are truly shocking. When we have chosen careers in surgery to save lives, it is incredibly upsetting to know that so many of our colleagues’ lives have been so deeply affected, and in some cases destroyed, by this abhorrent behaviour. 

“Let me be clear – there is no place in our operating theatres, or anywhere in the NHS, for sexual misconduct. NHS trusts need to take a long, hard look at whether their policies and procedures for sexual misconduct are fit for purpose, as do regulating bodies. And then where able, and supported to, surgeons may feel more comfortable calling out behaviour and reporting it.

“The Royal College of Surgeons of England is taking this issue incredibly seriously. We will not tolerate such behaviour in our ranks. I will personally be asking our Council members and leading surgeons to take that message back to their organisations.”

First published: 13 September 2023

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