Every patient has a right to expect that their healthcare is uncompromised by discrimination, bullying and sexual harassment in the practice of surgery.
Every surgical Trainee has a right to an education free of discrimination, bullying and sexual harassment.
Every International Medical Graduate has a right to be assessed on their merits, free of discrimination, bullying and sexual harassment.
And every healthcare worker – including every surgeon – has a right to a workplace free of discrimination, bullying and sexual harassment.
In this workplace, patient safety is the absolute and common priority. Teams work together effectively, respecting the skills, experience and contribution of each member. The success of surgical teams is measured by the safety of the workplace and training post, and by the extent to which all team members recognise that what they achieve together is more valuable than anything they can achieve on their own.
Workplaces like this exist now in some places in Australia and New Zealand. But they are a long way from the everyday reality of most people involved in the practice of surgery.
This must change. It is what both patients and surgeons in Australia and New Zealand deserve.
Effective change will take sustained commitment from individual surgeons, the College, public and private hospital employers, the healthcare sector and governments.
It will take a collective recognition that there must be a profound shift in the culture of surgery and an unwavering commitment to achieving this. Long-established traditions that have been inherited and have normalised unprofessional, and sometimes illegal, behaviours must be relinquished. Gender inequity must be addressed. Discrimination, bullying and sexual harassment must become problems of the past.
Everyone involved in the practice of surgery in Australia and New Zealand has a role in leading the way. With courage and purpose, on a foundation of transparency and independent scrutiny, a culture of respect and professional excellence in the practice of surgery can be built.
It will take individual surgeons meeting – and being held to account against – their legal and professional responsibilities to their patients, their trainees, their healthcare colleagues and their peers.
It will take bystanders speaking up and not being silent witnesses to discrimination, bullying or sexual harassment.
The College must be bold and embrace this opportunity to lead lasting, positive change by:
There is no room for bystanders. Employers, hospitals, governments, health professional and industrial associations, regulators and other partners in the health sector must also commit to sustained action.
It will take employers taking seriously their responsibilities to provide a safe workplace and governments supporting hospitals to do this. It will take new partnerships, committed collaboration and fresh approaches.
There needs to be a new, shared language that makes clear the risk to patient safety from discrimination, bullying and sexual harassment. There will be lessons for the rest of medicine, and the health sector more widely, to learn.
This does not involve trashing the past. It involves mindfully, deliberately taking what is best from the rich history of the practice of surgery and re-settling it on foundations of respect, transparency and professional excellence.
Nearly 50% of College Fellows, Trainees and International Medical Graduates report being subjected to discrimination, bullying or sexual harassment. It is inconceivable that anyone finds this acceptable or contests the seriousness and spread of these problems.
The status quo will not serve the future. Individually and collectively, College Fellows must recognise and commit to closing the gap between how it has been, and how it must become.
The Hon. Rob Knowles AO (Chair)
Dr Helen Szoke (Deputy Chair)
Mr Graeme Campbell
Dr Cathy Ferguson
Dr Joanna Flynn AM
Mr Ken Lay APM
Dame Judith Potter DNZM, CBE
Expert Advisory Group on discrimination, bullying and sexual harassment – Final report
A new RACS Support Program for Fellows, Trainees and IMGS has been launched through Converge International. Follow this link for details.
Further articles on Bullying and Sexual Harassment from Journal of the New Zealand Medical Association Vol 128 No 1424: 30 October 2015.
Bullying in surgery
Bullying in health care settings: time for a whole-of-system response
Peter Crampton, Tim Wilkinson, Lynley Anderson, Sue Walthert, Hamish Wilson
Bullying culture: Valuing the teacher-student relationship
Workplace bullying in hospitals: an unresolved problem