Issues faced by the female surgical trainees in developing countries

By Dr. Eshana Samaranayake

Across South Asia, women are still a small minority in surgical training programmes, and that imbalance shapes daily experiences in ways that are easy to miss from the outside.

‘‘Surgery is for men’’

I have wanted to become a surgeon since high school, but when I prepared for the entrance exam I heard frequent warnings from family, friends, and colleagues. Much of it was well-meant, yet it rested on an assumption: surgery is too demanding for women to balance with personal life, especially where women are expected to carry most household responsibilities.

Those expectations sometimes made me doubt myself, not because I lacked interest or motivation, but because I wondered how I would fit into a role society does not always picture for women. I feel fortunate to have been selected for surgical training, and I am now in my third year of general surgery residency. Despite the challenges, I remain grateful to be here and certain this is the right path for me.

‘‘Women may not be as suited to surgery’’

In some cultures, women are assumed to be less physically strong or less assertive than men. Women may also be expected to be quiet, while surgical training often rewards confidence, decisiveness, and visibility. Because of these assumptions, I sometimes feel I must work harder to be seen as capable. Like every trainee, I have days in the operating room when I do well and days when I learn through mistakes. But when expectations are filtered through gender, ordinary setbacks can feel heavier. Over time, these moments have strengthened my resilience and helped me grow, both technically and personally.

Mentorship and a sense of belonging

In my batch of thirty surgical trainees, only three are women. There are times I feel quite alone in the operating theatre, especially when I am surrounded by men and when there are few women seniors to look to for guidance.

Bias is not always obvious, and it may not always be intentional, but it can show up in small ways – who is encouraged, who is trusted early, and who receives reassurance when struggling. For a trainee, those small differences can matter. Senior women surgeons in my country are limited, and finding mentorship from someone who understands these experiences can be difficult. At the same time, I have been encouraged by the support I have received from certain teachers and colleagues, and I have also had younger women trainees reach out to me for advice – something that reminds me how important it is to support one another.

Way forward

Change becomes easier when more women are visible in surgical teams, leadership roles, and patient care. Alongside increasing representation, training programmes can help by building intentional mentorship, ensuring fair access to learning opportunities, and creating workplace cultures that value work-life balance for everyone – not only women.

Most importantly, young girls everywhere should be able to imagine themselves as surgeons without feeling they must defend their ambition. With supportive training environments and continued progress within both the surgical community and society, more women will be able to enter surgery, thrive, and mentor the next generation with confidence and pride.

Eshana Samaranayake, MBBS, MRCS, PhD 

Is a General Surgical Resident with a passion for teaching medical students. My research interests focus on advancing surgical practices in resource limited settings and improving patient care in developing countries. Outside of my surgical career I enjoy netball and rugby, and I enjoy spending quality time with my family and friends.