Challenges to the orthopaedic arthroplasty enhanced recovery programme.

We performed a retrospective study of patients undergoing total knee and hip arthroplasty on an enhanced recovery programme, to identify pre- and postoperative factors contributing to an increased length of hospital stay. Of 109 patients, only 61 (56%) were ready for discharge on the fifth postoperative day. The three most common reasons for delays were oozing wounds, postoperative medical problems and failure to reach physiotherapy goals.

Barriers to becoming a female surgeon and the influence of female surgical role models.

OBJECTIVES: We aim to investigate the reasons that medical students and junior doctors who are women are less likely to pursue a career in surgery compared with their male counterparts. METHODS: An anonymous questionnaire was distributed to female final year medical students and female junior doctors in two UK hospitals between August and September 2012. Topics included career choice, attitudes to surgery, recognition of female surgical role models and perceived sexual discrimination. RESULTS: 50 medical students and 50 junior doctors were given our survey. We received a 96% response rate; 46 medical students and 50 junior doctors. 6/50 (12%) junior doctors planned a career in surgery compared with 14/46 (30%) medical students. 'Work-life balance' was the main reason cited for not wishing to pursue surgery (29/46 (63%) medical students and 25/50 (50%) junior doctors). 28/46 (61%) medical students and 28/50 (56%) junior doctors had encountered a female surgical role model; only five students and two junior doctors felt that these were influential in their career decision. Of those who had not, approximately 40% in each group felt that if they had, they may have considered surgery. Approximately 30% in each group had encountered female surgeons that had dissuaded them from a surgical career. CONCLUSIONS: Work-life balance is still cited by female junior doctors as being the main deterrent to a surgical career. The paucity of female role models and some perceived sexual discrimination may cause female doctors to discount surgery as a career.