› RCSI Women in Urology
RCSI WOMEN IN UROLOGY A review of two recent papers on gender equality in urology by three RCSI alumni in the subspecialty, led to reflection on the wider issues facing female surgeons ith gender imbalance more marked in urology than in many other specialties, the focus now is on whether enough is being done to address the historical barriers, biases and cultural characteristics stopping women taking up urology. Two recent papers provide data illustrating the current extent of gender inequality, while offering hope this is set to improve. Earlier this year, Women in Urology: Breaking Down the Barriers (wchh. onlinelibrary.wiley.com) addressed the topic of gender inequality in urology in the UK. As of 2021, 12% of consultant urologists in the UK were female, compared with 13% across all specialties. However, 37.5% of current UK urology trainees are female. In Ireland, the percentage is higher at 58%. In Women in Irish Urology: An examination of female representation amongst attendees of the Irish Society of Urology annual meeting 2008-2020 (pubmed. ncbi.nim.nih.gov), the authors drilled down into the detail of women’s underrepresentation at surgical conferences. It will not come as a surprise to learn that session chairs and guest speakers were overwhelmingly male, as were oral and poster presentations. However, the authors noted increased representation of women in recent years. They called on societies to increase female representation as the best way to perpetuate a positive feedback loop, and encourage future female trainees to pursue urological surgery. Ms Catherine Dowling, FRCSI (2013), Consultant Urologist at University Hospital Galway, one of the authors of Women in Irish Urology, links the current gender imbalance to the historically lower number of women pursuing careers in surgery. “Surgery is perceived as a longer and more difficult path, attracting a harder, tougher person,” she says. “The low number of female urology consultants in the past meant a lack of female role models, and perhaps female medical students and early career doctors did not consider it a suitable career option.” Ms Bolton, FRCSI (2017), Consultant Urological Surgeon at Imperial College Healthcare NHS Trust in London, who credits Ms Dowling as an important mentor, did most of her urology training in Dublin, before going to the UK on Fellowship in 2018. She has been based there ever since, and was appointed as a consultant in 2020. She is one of two women on a 15-doctor urology team. She says that while gender balance has improved greatly over the last decade, there remain barriers to attracting women to urology. 10
Ms Catherine Dowling, FRCSI (2013).
“The low number of female urology consultants in the past meant a lack of female role models, and perhaps female medical students and early career doctors did not consider it a suitable career option.”
“Societal stereotyping and gender bias remain the greatest obstacles,” she believes, “as well as the lack of female urologists in leadership roles, as mentors and role models.” Ms Bolton points out that as 88% of urology consultants in the UK are male, medical students and junior trainees experience unconscious bias early on in their training, at a formative stage when they are developing interests and considering the direction of their future career. “It is important to recruit females in urology to deliver medical education and lectures in medical schools, as this is where the process starts,” says Ms Bolton, who remembers clearly the few female surgeons, including Professor Carmel Malone, FRCSI (2005), and Ms Ruth Pritchard, who delivered lectures and teaching and made her believe a surgical career was possible. “A lack of visible representation can make it difficult for aspiring female urologists to envision themselves succeeding in this profession. Carmel Malone was very charismatic and hugely inspiring to my generation of undergraduate students.” Ms Clíodhna Browne, FRCSI (2019) has recently been appointed to her first consultant post at Tallaght Hospital, having returned from Fellowship in Australia, and is heartened by the progress she sees. “Over 50% of urology trainees across all years are now female,” she notes, “so although we are still lagging behind in terms of consultants the pool of trainees has broadened. A good job is being done to attract women to the specialty but that takes a while to translate to consultant appointments.”
