UK Surgery’s #MeToo Moment – Next Steps

31 January 2022

This month, the Surgical profession publicly reckoned with its own #MeToo moment, following the article published in the RCS Bulletin ‘Sexual assault in surgery: a painful truth,’ which shone a light on the harrowing realities faced by many within the UK surgical community, and beyond.

The feature, authored by Orthopaedic Registrar Simon Fleming and Core Surgical Trainee Rebecca Fisher, has been the source of much discussion, outrage, and another wave of courageous disclosures - particularly those of Consultant Plastic Surgeon Philippa Jackson; and of the anonymous Surgeon who reported a shocking account being subjected to months of sexual harassment and assault by a Consultant, while she was an ST3. The incidents related occurred both in front of colleagues, and behind closed doors, and he threatened her career if she did not comply with his demands – reprisal followed. Dozens more personal accounts of unacceptable, predatory behaviour continue to circulate on social media.

Whilst this has been a challenging period of recognition for some, and an eye-opener for others, the Confederation of British Surgery commends the authors for their brave work in addressing a long overdue and highly important topic, which has since gone on to generate attention in the mainstream media – notably in the Times.

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The original article highlighted that these, and other criminal acts, and the rampant toxic attitudes and cultures that allow them to perpetuate are not limited to a single region of the world. Indeed, they have been unfortunately encouraged to flourish, as victims are often additionally negotiating imbalances of power; a system that discourages reporting; processes that do more to retraumatise victims than they do offer consequences for, or protection from, those who harm them. This is without also considering that victims will often be forced to ‘weigh up’ whether potential long-term consequences to their careers will be ‘worth’ the risk of reputation damage, or, more concerningly, reprisals from their attackers, or within their professional networks.

When CBS originally posted our response to the article in the form of a short video, it was yet another wake-up call to how this issue extends well beyond any single professional community: simply using the terms ‘sexual assault’ and ‘sexual harassment’ in the accompanying text caused the @UKSurgeons Instagram account to be banned from posting on the platform for nearly 5 days. Whilst social media is, of course, not “real life,” it is arguably a place where, as a result of the algorithms, both good and bad information can be amplified drastically – and we note disheartening parallels with systems set up to silence essential discussion.

That which ‘cannot be named’ can never truly be discussed in earnest, nor can actions be taken to resolve what is unspoken – which is why this watershed moment that has evoked myriad emotions and reactions among our Surgical colleagues, has been critical.

We have often highlighted the importance of bystander intervention training, and the crucial need to recognise when, where, and how we need to act and stand up for our colleagues. Recognition, and accountability are fundamental to enact long overdue change, and eradicate the toxic culture that leaves our colleagues’ safety and wellbeing at risk – whether that risk constitutes ‘unprofessional’ behaviour; more serious, criminal acts; or a system that extrapolates on existing power dynamics and routinely punishes victims more than their offenders.

We must also recognise that, whilst surgery has historically been, and is currently a male-dominated profession (the latest statistics show that in 2020, 13% of Consultants were female), the culture and attitudes pervasive in any profession will certainly play a role in dissuading many individuals from following a desired career path. Within the Surgical community, that loss of potential equates to a loss of talent and innovation detrimental to the profession, both in the UK and internationally.

As a trade union for all surgeons, we know that we are stronger together – and we have already observed concerning trends (as highlighted by groundbreaking research published in August 2020) of many Surgeons considering changing specialties, or leaving the profession altogether, as a result of the challenges and risk presented by the COVID-19 pandemic. Not only does the culture need to change to keep our colleagues safe, it needs to change in order to attract and retain the brilliant Surgical talents of those who have historically been asked to negotiate systems that have not been set up optimally to meet their requirements.

Finally, we want to reiterate the Confederation’s solidarity with victims - whether they have reported incidents, or have been silenced by a toxic culture and system that has failed to protect them. We also recognise that in the wake of so much discussion, it may be especially challenging to survivors, who may or may not want to disclose their own stories; be in the position to make disclosures, and/or who may still be in an ongoing situation, or at risk of further harm.

We want to reinforce the message to those survivors that you are not alone, and the Confederation of British Surgery are here to support you, if and when you decide to disclose - and we will do all we can to ensure you are safe and protected.

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