“The woman is not for surgery”. Life is not an easy life for surgeons in Poland

325 years. Exactly that long has passed since the surgeon’s diploma went to a woman for the first time in Polish history. Magdalena Bendzisławska made a breakthrough, but did not change the position of her colleagues permanently. There are still not many surgeries in Polish hospitals. But there are too many challenges and stereotypes they have to face. We talk to Dr. n. med. Magdalena Wyrzykowska, surgeon and member of the board of the “Women in Surgery” foundation.

1. Medical graduates more and more often choose the surgical specialization, but men are still dominant among the experienced staff
2. Surgeons in Poland are often removed from operating and delegated to administrative tasks, which further reveals the indulgent attitude towards their competences
3. There is even a bad joke that we keep hearing in hospital corridors. A female surgeon is like a guinea pig – neither a guinea pig, nor a guinea pig, that is, with us: neither a woman nor a surgeon – says Dr. Wyrzykowska
4. The general situation of surgery in Poland, assessed by the surgeon as very bad, overlaps with gender-related problems.
5. – Polish surgeons are physically and mentally damaged, and exhausted and burned out people do not constitute a potential to work in this profession, let alone educate younger colleagues
6. Check your health. Just answer these questions         
7. More information can be found on the TvoiLokony home page         

Paulina Wójtowicz, MedTvoiLokony: Is a female surgeon still a rarity in Poland?

Magdalena Wyrzykowska, MD, PhD: Definitely yes. I can see it from my patients’ reaction to my sight, but also when I meet with various scientific bodies, where women are usually absent, at best there is one. It is the aftermath of the ossified, male-dominated structures of the previous generation, including mine. Fortunately, the situation is slowly changing. More and more women choose treatment specializations, there are wards where there are one or two residents for a few residents. So the proportion is reversed, but it takes time for it to be noticeable “in the field”.

How do you assess the situation of surgeons in Poland?

In order to present a picture of the situation of women in this area of ​​medicine, one would have to start by outlining the situation of Polish surgery. And this one is very bad.

Dlaczego?

There is no single, simple answer to this question. First, though not the most important thing, there are very few surgeons in Poland. Secondly, the average age in this profession is over 60 years, and the profession of surgeon burns you down very quickly. XNUMX-hour shifts, night work, being constantly on the alert, living in constant tension and stress – all this will damage your health at an express pace. Fatigue and burnout increase over time.

Polish surgeons are physically and mentally damaged, and exhausted and burned out people do not constitute a potential to work in this profession, let alone educate younger colleagues. Another thing is that there are also toxic people among young doctors. When someone is self-centered, they will find neither the time nor the willingness to share their skills.

Guilty system?

Over the last three decades, the work of a doctor in Poland has changed dramatically. New standards of patient service have emerged, which is associated with a huge number of procedures and formalities. The patient has some benefits, he is certainly more protected, but the doctors are overwhelmed by it, because no one has relieved them of their remaining duties, but only added new ones. And now, if we have a 60-year-old surgeon – to whom I bow to the fact that he still has the strength to work – who has never had to worry about such formal issues, and now he is covered with them, and to all this he adds a young doctor to training, he has the right to be tired and frustrated. This is too much for one man.

1. The doctor alerts: You can die of overwork. There is scientific evidence for this

The patient has to be examined, the documentation has to be completed, so something has to be let go. My guess is it will be a resident.

Unfortunately. There are very few good centers for specialization in Poland. This is not only my private experience, but the experience of entire years, indicated by medical university graduates as the biggest professional problem. It seems that everything is correct: the paper is, the stamps are stamped, but this young man does not leave the hospital with as skill as he could, if he had been given more time and attention. A resident is treated as an employee of “black work”, papers, and possibly assistants. He is not thought of as someone who should learn something, more as a free worker.

There is still a problem of mobbing in many hospitals. Surgery is a specific field in that the resident is very dependent on his mentor or, in this case, a fake mentor, because he is the one who passes on to him all the practical knowledge about this profession. If this relationship is toxic, it strongly affects the young doctor’s entire professional life. As a result, new staff enter the profession burdened with bad experiences and standards of poor quality. All this discourages young people from choosing this specialization. The gender-related problems also overlap.

Some argue that women do not have the strength to operate for hours.

There is even a bad joke that we keep hearing in hospital corridors. A female surgeon is like a guinea pig – neither a guinea pig, nor a guinea pig, that is, with us: neither a woman nor a surgeon.

However, answering the question: there are many myths around physical prowess in surgery. Meanwhile, today, in the era of automation, it really does not matter that much. Of course, being 160 cm tall, I am not as sturdy as a two-meter-long friend, but do I really need it? This is not battlefield medicine. There are always several people in the operating theater, so even moving a patient from bed to bed is feasible. But a burqa stick will always be found – if someone wants to bother surgeons, they will use any argument, including those related to physical strength.

1. See also: Robots can help medicine, but the training of surgeons needs to change

This is not the only stereotype related to the perception of women in surgery.

It is also said that surgeries are very accurate, although in this profession it is both an advantage and a disadvantage. An advantage, because it guarantees precision in the preparation of the patient and the performance of the procedure itself, it also has a positive effect on the relationship with the patient. However, it cannot be denied that it can be tiring. Dividing the hair into four is stressful. Constantly thinking about not missing something, not making a mistake, not making a wrong move, the pressure to keep an eye on everything is very stressful. This is a problem that most women working in interventional medicine face.

It happens that women are removed from tasks that are obvious for their colleagues, a permanent duty in their daily schedule?

Commonly. The attitude towards surgeons is mockingly and indulgent. Women are treated as ward mascots, people to help. They mainly deal with secretarial work related to the organization of work. Once our foundation received a letter, the author of which described the situation in which her boss put her. She heard that she was to work in the clinic, because the woman was not operated on. This is an extreme case, but unfortunately there are also such.

What is the access of women working in surgical medicine to training? Are the doors to a scientific career open to them as wide as to fellow surgeons?

Of course not, but it is rarely stated explicitly. Everything happens in the non-literal layer. It’s not like someone comes into a room and says: “you and you are not going to develop, we are blocking your access to training.” Most often this is done by promoting some employees at the expense of others. There are people marked for development and the rest are meant to support them, in a losing position, you do not invest in them. They are very often women. There is still a lot of nepotism in medicine. People from some social key are promoted, and everything remains at the discretion of the boss.

The rest of the conversation under the video.

There is another challenge: motherhood. First, a physically demanding pregnancy, then a break from work, and in addition, everyday life in the form of, for example, care for a sick child and pre-school and school logistics. How, in the context of XNUMX-hour on-call duty, being constantly on-call, combine the role of a mother with working in surgery?

It cannot be combined. In terms of facts and planning, you just honestly can’t do that. Despite this, women do it, decide to be a parent and then face this challenge on a daily basis, arranging their lives somehow. Anyway, no matter what the job is – it will always be done with enormous effort and at the expense of something else.

What is the greatest difficulty for you?

Shifts. They break the rhythm of life remarkably. It is very difficult to plan babysitting and share responsibilities with your partner when you are away all day and when you come back you are half alive.

My guess is that this scenario may discourage some young doctors from starting or growing a family.

Very. Many choose not to have children at all, others do so very late. It is difficult to consciously decide on motherhood without systemic facilitations: flexible working hours or even equal access to training. Without it, we are in a losing position, because if the boss has a surgeon who has to pick up the child from the nursery at 16pm, and a surgeon who is as free as a bird and can devote himself to education 100%, the choice is obvious. I dream of creating nurseries and kindergartens for employees’ children at hospitals. It would make our lives so much easier.

Are bosses understanding?

It’s not about forbearance, I don’t need it. If I expect your understanding, it means that I have done something wrong that someone has to forgive me and show my generosity. We should not think of motherhood or parenthood in these terms. After all, it is my right to give birth to a child. Moreover, it is my work for the benefit of society as a whole – I deserve basic respect for that. We need to stop talking about motherhood as something that needs an excuse for which we should apologize and expect forgiveness. I can expect, however, that the system will be constructed, or rather changed, in such a way that I can combine professional and family responsibilities.

What is the issue of psychological support for surgeons and surgeons?

In Poland, no one is interested in the psychological well-being of medics. Nobody cares how a doctor feels when a patient dies, although the death situation is just one of the many stressful moments in this work where psychological support could be needed. I wish everyone to work in good teams that support each other, because there is no systemic in this country. Our strength is how we treat each other and what support we offer each other. The fact that we generally don’t give it to ourselves is another matter.

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Why did you choose surgery?

I never know how to answer that question. Life is ruled by chance. I like to emphasize it, because our choices are not always tactical and thoughtful. I do not come from a medical family, I am a doctor from the so-called the second category – no manners, no backs, taking me through my professional life. The choice of surgery was a child’s play. It seemed to me that it would be a great job, such a dream come true of being a superhero, a one-man A team.

Life verified it a bit, it burned this joy and enthusiasm in me. Fortunately, not entirely, because I try to be and work in this profession all the time. When my husband asks why I will not give up on duty hours, for example, I cannot answer. This work is like a drug – it is addictive, it cannot be replaced by anything else. It is a beautiful profession, only the circumstances of its practice need to be changed. I still hope that it will be better in Polish surgery.

We encourage you to listen to the latest episode of the RESET podcast. This time we devote it to emotions. Often times, a particular sight, sound or smell brings to mind a similar situation that we have already experienced. What opportunities does this give us? How does our body react to such an emotion? You will hear about this and many other aspects related to emotions below.

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