Increasing women's motivation to embark on and succeed in the surgical career.

This proposal seeks support for Peters and Ryan to partner with the Royal College of Surgeons (RCS) and Scalpel (the UK's largest undergraduate surgical society) to translate their previous ESRC-funded research into a package of Women in Surgery (WIS) interventions designed to boost women's motivation to embark on and succeed in a surgical career. This intervention is both timely and essential for the long-term wellbeing of the UK public. First, by increasing women's surgical career motivation the interventions promise to redress the systematic underrepresentation of women in surgery. While women now dominate UK medical schools they are far less likely than male colleagues to pursue a career in surgery and even less likely to qualify as consultants. Second, by encouraging the women who increasingly dominate the undergraduate talent pool to pursue and succeed in a surgical career, the interventions will ensure the UK public has access to the surgical skills that it requires. The UK is currently experiencing a shortage of surgeons and the rapidly aging population will exacerbate this problem. Third, by increasing women's motivation the interventions will reduce NHS costs associated with the high turnover of capable female trainees.
The WIS interventions are a direct application of Peters and Ryan's recent research which revealed that identity-based processes account for women's lower levels of career motivation in high status occupations. Specifically, the research demonstrates that women are likely to perceive that they do not fit in with the stereotypically masculine image that defines high status occupations like surgery. Importantly, this perceived lack of identity fit reduces women's motivation to pursue the occupation in the first place; and amongst those who have already embarked on this occupation, it reduces their motivation to succeed and increases their inclination to 'opt-out'.
We seek to apply these findings in a package of interventions designed and run in collaboration with the RCS and Scalpel. The interventions seek to target women's surgical career motivation using a three-ponged approach that consists of (a) a seminar series, (b) a platform of multimedia resources and (c) a programme of intervention evaluation. The WIS Seminar Series will target medical students and surgical trainees at top UK conferences to disseminate knowledge about the role of identity-fit dynamics in the motivation of women. The Seminar Series will also directly bolster women's perception of identity fit by increasing the visibility of female surgical role models who challenge perceptions that surgeons are, or need to be, only a particular kind of person. The interventions will be reinforced by ensuring the conference is a gender-sensitive environment where key organisations are given the opportunity to communicate their commitment to diversity. One key seminar will be presented at a medical educators conference and will focus on the dissemination of knowledge so that those who are best placed to monitor and manage the surgical career pipeline understand the issues and are empowered to institute their own interventions.
To ensure that the dissemination and intervention components of the Seminar Series can be directed towards a national audience on an ongoing basis, the series will be complemented by a platform of multimedia resources including a WIS Vodcast, WIS Seminar Series Website and a WIS Support Network. Finally, an evaluation programme will accompany the interventions to document their effectiveness at increasing the motivation of seminar attendees (versus non-attendees), both immediately and in the months following the intervention. Where possible indicative behavioural information will be gathered. This will inform future seminars, ensure that the RCS and Scalpel implement best practise to increase the presence of women in surgery and to inform future research.

This project is likely to have multiple impacts. We anticipate that the knowledge-exchange activities will have (1) academic impact (for psychologists, management theorists, and medical academics), (2) organisational impact, by informing practices and policy within medical and surgical training, (3) impact directly on female medical students and surgical trainees, and (4) broader societal impact, by contributing to the increase in the number of female surgeons.

Academic Impact
These knowledge-exchange interventions are likely to be of interest to a range of academic disciplines, including social and organisational psychology, management studies, leadership studies, and medical academics. We are in the process of publishing this work in collaboration with academics from a number of these disciplines, and it is hoped that these follow-on activities will facilitate this inter-disciplinary publication process.

Organisational Impact
By disseminating our previous research in the form of innovative knowledge-exchange interventions we seek to directly influence policy and practice in medical and surgical training. By promoting interventions that directly address the underrepresentation of women in surgical training and by increasing the number of women who successfully complete their training we hope to extend the talent pool from which the NHS can select surgeons and contribute to cost efficiencies in the NHS training budget.

Impact on Female Medical Students and Surgical Trainees
Women now represent almost 60 per cent of UK medical students (British Medical Association, 2004). However, they represent only 16 per cent of surgical trainees and only 8 per cent of NHS surgical consultants. Our knowledge-exchange interventions aim to increase the attractiveness of the surgical career to female students and thus support gender equality in the medical profession. By improving identity fit among female medical students, the project should increase the number of women applying to specialise in surgery. By improving identity fit among female surgical trainees, the project should increase their motivation to succeed and decrease their desire to opt-out of training.

Broader Societal Impact
The RCS (2010) estimates that within the NHS almost all surgical specialties are under-staffed. Given that current demographic trends, such as an aging population and the forthcoming retirement of the baby boom generation, will only exacerbate this shortage, the demand for surgeons will only increase. We know that surgery is involved in one in three UK hospital admissions (2008-2009 Hospital Episode Statistics data), that 8 per cent of people will have an annual operation, and that almost everyone will have surgery at some point in their life (RCS, 2011). Therefore, the shortage of surgeons will have a detrimental impact that will be felt by many. By increasing the representation of women in surgery we hope to help address current and future shortages in the number of UK surgeons so ensuring that the well-being of the UK public is not compromised.