Barriers and facilitators to implementing Women in Surgery initiatives at UK medical schools: A qualitative study.

Background: Despite women comprising over half of UK medical school graduates, they represent only 17% of consultant surgeons. This imbalance limits female students' access to mentorship and career opportunities. Specialised Women in Surgery (WinS) programs at medical schools are key initiatives to address this imbalance and support aspiring female surgeons. Methods: This cross-sectional qualitative study surveyed 24 UK medical schools through semi-structured interviews with 53 representatives between October and December 2024. Data collection employed a mixed-method approach using open-ended and Likert scale questions (1-5), followed by thematic and quantitative analyses. Results: Of 24 participating UK medical schools, only 10 (41.7%) had an active or developing WinS initiative. Institutions with WinS programs reported higher engagement in gender equity and greater student awareness. The value of WinS was rated highly (4.5/5), with strong student demand (83.3%). The most significant barriers were high workload and lack of student time (mean rating: 3.33), funding constraints (mean rating: 3.01), and insufficient access to female surgeons (mean rating: 2.86). A key divergence emerged where universities without WinS programs struggled most with accessing female surgeons, while those with WinS programs identified funding as their main challenge. Conclusion: With only 41.7% of UK medical schools having established WinS initiatives, there is a critical need for coordinated national support. A framework providing shared resources and networking opportunities could transform isolated programs into an effective support system. These findings offer actionable recommendations to address inequities and empower future female surgeons.