Male and Female surgeons - is there a difference in surgical outcomes?

In a recent study it was revealed that the difference in the outcome of surgeries carried out by male and female surgeons is the slightly lower postoperative death rates from female surgeons. This was shown in a study done in Canada published in ‘The BMJ Today’.

Researchers stated that while the results do not conclusively set out cause and effect, neither do they show preferential selection in the sex of the surgeon carrying out the procedure.

Very little research has been carried out as to the differences in learning techniques between male and female surgeons. Neither is there much information about the acquisition of skills between the two genders.

In a team led by Raj Satkunasivam, who is a Houston Methodist surgeon and researcher, a study was done on the outcomes of patients who underwent surgery by different gender surgeons. The goal of the study was to see whether – in a traditionally male profession – there was a difference in patient recovery.

The study compared patients who underwent one of twenty-five procedures carried out by a female surgeon, to the same procedures carried out by a male surgeon. The studies were all carried out at the same hospital in Ontario, Canada.

To make sure that the groups were balanced equally, the surgeons were selected based on similar age, experience, and number of operations carried out in the previous year. The patients were chosen based on similar age, gender, and income.

The outcomes of the surgeries were measured by the number of deaths after surgery, readmissions, and any complications within a month after the procedures.

3,314 surgeons took part in the study, and a total of 104,630 patients participated, with a breakdown of patients as 774 females, and 2,540 males. The study was carried out over a period of 8 years.

The results found that while there was hardly any difference in readmissions or postoperative complications, patients who had been operated on by a female surgeon had slightly lower odds of dying within a month.

Another aspect of this study was the outcomes of patients who had undergone emergency surgery, and had no choice in the selection of surgeon. Even considering additional influencing factors such as mixed cases, there was no great difference in the results.

Although the reasons for the difference is not very clear, it is suggested that female surgeons may be working more in line with the guidelines, may also be more patient centred, and be better at communicating with patients.

The study team stressed that this was more of an observational study, so no definite conclusions about cause and effect were made. However, the findings suggest that perhaps there should be more investigation into the outcomes of procedures, and the pattern of after care.

The team concluded that their findings had made it clear that there should be more support for equality and diversity in what is traditionally a male profession.

Replying to the study, Clare Marx and Derek Alderson of the Royal College of Surgeons of England said that while the study showed that women were just as safety conscious, and skilled as men, whether the surgeon was male or female was irrelevant.

More important is to improve surgical outcomes, say Marx and Alderson. There is a tendency for surgeons to focus on clinical end points, while hospitals may be more concerned with saving money.

Taking into consideration the number of critical issues to consider, the act of trying to work out why such a small difference in the outcomes between male and female surgeons exists will not prove worthwhile. They conclude that the sex of the surgeon should not emerge as an important issue for the successful outcome after surgery.


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