Bridging the Gap: Female Surgeons in Malawi and the Power of Representation
November 19, 2025
By Dr. Sharon Cheryl Bonya
Female surgical trainees face structural and cultural barriers that extend far beyond the operating room. They are not just training to master technical skills, they are also navigating expectations, isolation, and leadership in spaces where their presence still surprises many.
In Malawi and across much of Sub-Saharan Africa (SSA), female surgeons face a double burden: under-representation within the surgical workforce and the cultural headwinds that make leadership, mentorship, and progression more difficult. Despite recent gains in training capacity in East, Central and Southern Africa, women surgeons remain a minority with implications for patient trust, communication, and equitable access to surgical care.
According to the NHS workforce data, women make up about 17% of general surgery consultants in the United Kingdom. In the United States, women account for roughly 22.6% of general surgeons, based on figures from the Association of American Medical Colleges (AAMC). These numbers show a clear pattern that even in high-resource settings, women remain under-represented in the field of surgery. According to recent workforce reports by the College of Surgeons of East, Central and Southern Africa (COSECSA), women make up only about 10% of surgeons in the region. Some countries in SSA, including Malawi, show a promising increase of women surgeons and have among the highest proportions of women specialists in the region, but the absolute numbers remain low.
When I started my General Surgery residency with the Pan African Academy of Christian Surgeons (PAACS) and the College of Surgeons of East, Central and Southern Africa (COSECSA), there was one senior female trainee ahead of me. Her presence mattered. She was living proof that a woman could thrive in surgery as a leader. She navigated her way under pressure, modeled authority in theatre, and emanated strength in a system that often overlooks women. When she completed residency, I became the only female resident in my program. Surely, that moment came with pride but also with the weight of representation. As a senior resident, it meant taking on leadership in ward rounds and theatre, and delegating tasks while carrying the invisible responsibility of representing what female leadership in surgery can look like.
Being the sole woman in the room often means being both hyper-visible and unseen, expected to excel, to prove, and to endure. Cultural expectations still question women’s place in surgical leadership. Fewer women in senior positions means fewer role models and shared experiences.
For many patients in Malawi, particularly women, gender dynamics also shape care-seeking behavior. According to studies on gender concordance in healthcare conducted globally, cultural expectations, stigma, and financial limitations can discourage women from seeking surgical care. This aligns with evidence highlighted by the Association of Women Surgeons (AWS) that representation improves both patient trust and health-seeking behaviors. In this context, the presence of female surgeons becomes transformative, building trust, comfort, and safety for female patients who may otherwise hesitate to seek care.
Representation is powerful. When a woman leads in surgery, patients often feel more comfortable and more willing to open up. Conversations that might have remained silent become possible. And when surgical teams are diverse, communication deepens, collaboration strengthens, and the culture of care improves.
These challenges have shaped how I lead and take care of patients. I’ve learned to advocate, to mentor, and to build spaces where others can feel seen. When a young medical student sees a woman confidently leading in the operating room, her imagination expands. She begins to picture herself in spaces she once thought were unreachable. For female surgical trainees, the journey is not only about learning to operate, it’s about navigating barriers that question their very place in the operating room. The experience of being one of the few women in surgery is both isolating and deeply significant.
As a woman in surgery, I know I hold a unique and powerful position where surgical leadership is shared and where mentorship, leadership, and research opportunities are in place to help women enter and thrive in surgery. I’m not just operating on bodies, I’m opening doors.
Representation is not a luxury. It is, however, a catalyst for trust, access, and change.
Author Bio: Dr. Sharon Cheryl Bonya is a General Surgery Resident with the Pan African Academy of Christian Surgeons and the College of Surgeons of East, Central and Southern Africa, training at Malamulo Adventist Hospital, Malawi. She is passionate about surgical equity, mentorship, and advancing women’s leadership in global surgery.
Links to citations that were requested:
For the NHS data:
https://www.rcseng.ac.uk/careers-in-surgery/women-in-surgery/statistics/?utm_source=chatgpt.com
Article: Newman TH, et al. BMJ Open 2022;12:e055516. doi:10.1136/bmjopen-2021-055516
For the AAMC data: