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They are going to welcome our next speaker now. So our next speaker will be MS Greta mclachlan. She is a general surgery trainee KSS. She's a member of the woman in surgery forum. She is trainee lead of the working party on sexual misconduct in surgery and a co founder of women speakers in healthcare morning, everyone. Thank you very much and well done and premensa my name correctly. I appreciate that. Um Good morning everyone. And thank you to Asset for inviting me to talk on such an important healthcare topic. My name is Greta mclachlan. My pronouns are she and her and my Twitter is up on the slide. So please feel free to tweet as we go along. I'm gonna be talking to you today about the working party on sexual misconduct where we are now. And how did we get here? First off, I want to make a note that I'm going to be talking about harassment and I'm gonna be referencing assault and rape. During this talk. The working party on sexual misconduct and surgery is a group of working surgeons, consultants, trainees, specialists and sexual misconduct and research. We came together after the publication of two articles in particular that were published in the Royal College of Surgeons of England bulletin at the end of 2021 beginning of 2022. I'm sure some of you are aware of this. One of which uh written by Philippa Jackson spoke very candidly about being sexually assaulted in the surgical workplace. This sparked a huge conversation online as well as reaching mainstream media and was heralded as a me too moment in for surgery. By the times it also led to the then Presidente of the RCs England issuing an apology in a statement that stated, we are outraged, appalled at the testimonials of sexual assault in the surgical workplace that have been shared on Twitter. We've been aware that there needs to be a cultural change in surgery for some time. But these revelations have shone a light on the very serious issues of sexual harassment and assault in surgery. It is not new that sexual misconduct has been happening in surgery or medicine for that matter. In fact, there has long been anecdotal evidence and discussion's and whispers and corridors around the topic, but often it has been downplayed as something that has happened in the past and is not a current issue with such quotes from 2018 in terms of sexual harassment, male surgeons touching women. I don't think that's happened in 20 years. I'm not saying it doesn't exist, but it's not a major feature in the UK, sadly, this doesn't seem to be the case. One small scale study found that 18% of medical students have been harassed whilst on surgical placements. Now, I can't imagine that those students would want to enter the surgical workplace professionally. Why would they, we want surgery to be a diverse workforce, but we're losing surgeons before they even qualify. This has also been reflected in evidence that women are leaving surgery due to sexual harassment. Now, sadly, often the perpetrators go on working with no consequence or workarounds, for example, not sending them female trainees or students. This is a true example. It is often noted that harassment thrives in areas predominated by men in the UK, only 13% of the consultant body is made up of women. Harassment also disseminates and cultures that have differentials of status, prestige and power. Sound familiar. We know that surgery can be a ripe ground for harassment but what's been done about it so far? Sadly, not a lot or not as much as should have been done. We don't know the true scale and depth of the problem yet there have been various surveys that have looked at harassment but mostly have been small scale or have been tagged onto bullying and undermining surveys. If they're bundled together, it's easier to ignore or find holes in the research or argue that it's not a representation of what's really happening or it's not happening in my region. This uncomfortable data can be made very comfortable pretty quickly. But we don't want that. Oh sorry, we don't want that. We want things to change. We want the uncomfortable data and the uncomfortable truth and find out if this is happening and we know that it is where often and by whom in order to change the culture, we need to ask the questions and we need to ascertain the problem and this means surveying the population. So the working party created a survey asking some pretty uncomfortable questions. We gained consent and asked for basic demographics about gender, sexuality, region of training, specialty and age group, etcetera, etcetera. We gave definitions of harassment, assault and rape so that we were clear what we were asking about. We then asked if you had been a witness to any of these incidents of harassment, assault or rape or if you've been a target or a victim of harassment, assault or rape. We asked follow up questions about the incidents and then asked if they had occurred within the last five years. We also wanted to find out about how people fail these incidents are currently being dealt with by the various regulatory and statutory bodies. The survey was available for about three months and was spread via email, mailing lists and shared on social media. Here are some of the examples of what we asked about jokes with sexual content, unwanted sexual talk or comments, threats of punishment or adverse consequences, touching of somebody's genitals or breast tissue without consent, self fondling by perpetrators, rape in the workplace or rape in any other related context. We made sure that there are advice lines and reporting numbers at the end of the questionnaire and all data was handled by outside sources that uh anonymized the details of those that have been reported. And anyone that was named, one thing that I want to talk about before we move on is that of jokes, many people feel as though you can't say or joke about anything anymore. Firstly, I would say to those people, what was it exactly you wanted to say or what exactly was the joke you wanted to make? We want to make sure that surgery is a safe working environment for everyone. So if you're questioning whether or not you should make that joke, you probably shouldn't. And here's why, but it's just banter. Actually, it's not Romney's QC and her investigation into sexism in the B M A clarifies the fact that if there is a power differential, then it's not banter. It's harassment. This includes jokes. It's easy to understand why touching someone's genitals at work is unacceptable. Why rape is unacceptable. But jokes are harder for people to grasp. Sometimes jokes speak to the culture of the community. It speaks to what and who is accepted, who is the outsider, who has the power and who can get away with these microaggressions and assaults. Think about who is the punchline of these jokes. Who is it making fun of? Why is that funny? This is the pyramid of violence. There are many different versions of this pyramid that all relate to different types of discrimination. But this does show you from the bottom and based on biased attitudes and beliefs that there is a continuum from jokes, either sexist, misogynistic, sexual content related or rape based that lead directly to actual rape and murder. They layer on top of each other building up to the top of the pyramid in progressive allowance of transgressions. When we permit jokes and banter, we are signaling to those who wish further harm that they are safe in this culture and this environment that there are no repercussions for their actions and it signals to them that they can abuse as they like. This is why sexist misogynistic sexual content related jokes in the workplace are harmful. They are not banter the result, the results of our survey. Well, they're significant. Unfortunately, our results are on embargo at present as we're working to get the results published and use them as a lever for change amongst our royal colleges and regulatory bodies. We have a roundtable planned in May for key stakeholders to discuss our findings and how we can implement change in the working culture. There will no doubt be media interest. Some of us will be shocked by the results. I think sadly, those of us who have been paying attention will not be surprised. I want to finish on this quote from s statue from the lancet about those who abuse power and healthcare, we cannot provide respectable, safe and equitable care for patient's. If we're not treating our fellow workers that way, because that's what it's about. At the end of the day, it's about providing safe care for our patient's and a safe working environment for ourselves. Thank you very much. Yeah. Thank you so much for this excellent presentation. We're now finishing this session.