International Women's Day 2022: Women & RCSI

Gender is one of the core pillars of equality, diversity, and inclusion implementation at RCSI, with our dedicated EDI Unit spearheading various initiatives that promote equality between women and men and embrace the right of all individuals to be treated equally regardless of gender identity and gender expression.

RCSI has had strong gender parity among medical graduates now for more than 20 years. Like the broader medical profession and other medical teaching and training establishments in Great Britain and Ireland, however, that parity has been a long time in the making.

RCSI Medical School Class of 1970

Much of the recent history of medicine and surgery – like comparable professions such as law – has been almost the sole preserve of men. Interestingly, the early development of ‘professional’ surgical practice within the various guilds and corporations of barber-surgeons in Great Britain and Ireland in the late medieval and early modern period was probably more inclusive of women than it was in the later eighteenth and nineteenth centuries. In Ireland, for example, women were permitted to join the Barber Surgeons Guild of Dublin in 1576 under a Royal Charter issued by Queen Elizabeth I (though the extent to which women actively participated in surgical practice is not clear).

Charter from Queen Elizabeth to the Corporation of Barbers Chirurgeons in Dublin, 1576 (IE TCD MS 1447/1)

".. to consist of themselves and other Persons as well Men as Women and to receive admit and accept of any other Persons whatsoever fit and discreet and freely willing to Joyn them as Brothers and Sisters of the Fraternity or Guild aforesaid."

This early inclusivity began to erode in the eighteenth and nineteenth centuries as the roles of men and women in society became more sharply defined than ever and women’s sphere of activity and influence was increasingly confined to the private sphere of the home. Men consolidated their role in the public spheres of government and society at the same time as the practice of medicine and surgery was becoming ever more professionalised, making it harder than ever for women to even enter the classroom, never mind break the glass ceiling.

Access to education was a significant barrier to ambitious young women. Girls were rarely afforded as intellectually rigorous or well-rounded an education as that received by boys: though she was generally well-read, the skill set of an accomplished young women in society was often deemed to extend no further than a thorough knowledge of the arts as well as proper etiquette and deportment. Women were routinely excluded from higher education and the professions on the grounds of the social and biological inferiority prescribed by their gender. Indeed, an 1873 publication titled ‘Sex in Education’ went so far as to warn against female participation in higher education on the basis that “higher education in women produces monstrous brains and puny bodies, abnormally active cerebration and abnormally weak digestion, flowing thought and constipated bowels.” Hmm.

Female students were finally permitted to enter RCSI under the terms of a Royal Charter issued by Queen Victoria in 1885. This same Charter also granted women permission to sit the Licentiate and Fellowship examinations at RCSI:

"And we do hereby, for us, our heirs and successors, grant, declare, and appoint that all provisions of the Charter, Bye-Laws, and Ordinances as to education, examination, and granting diplomas to Fellows or Licentiates shall extend to include women."

Despite this, and perhaps unsurprisingly given the social context of the time, women remained in the minority at RCSI for many years to come. The first female student, Agnes Shannon, entered RCSI in 1885, while Emily Winifred Dickson holds the joint honour of becoming the first female Fellow of RCSI in 1893 and thereby the first female Fellow of any of the surgical royal colleges in Great Britain and Ireland. Ten women appear in the Roll of Licentiates during the first decade of their being permitted to sit the Licentiate examinations that allowed them to practice. By 1915, just 5% of registered medical students at RCSI were women.

Emily Winifred Dickson and male colleagues pictured on the steps of the Whitworth Hospital in Dublin, 1896

The number of women entering and graduating from medical school increased dramatically in the 1960s. In the period 1965-2005, the percentage of female students graduating in medicine from RCSI was on average 32%, with the ratio of male to female students increasing steadily during this time before finally tipping in favour of women for the first time in 2003 with 53% female graduates. This trend continues today with a split of 53% female vs 47% male across the RCSI undergraduate medical student population in the 2020/21 academic year.

The list of female firsts at RCSI might begin in 1885 but it continues to grow apace to this day. Just over a decade ago in 2010, RCSI elected its first female President, Eilis McGovern, in the College’s almost 240 year history. In 2017, RCSI published a comprehensive report, PROGRESS: Promoting Gender Equality in Surgery, which highlighted that despite more than 20 years of gender parity among medical graduates, the proportion of female consultant surgeons remains low at <7%.

Participation and representation of women in surgical practice and in leadership and management roles across the healthcare community remain key drivers for gender equality at RCSI today. We’ve come a long way, but there’s a long road ahead as well.