“I always wanted to be a surgeon,” says first UK female professor of surgery Averil Mansfield
Professor Averil Mansfield spent over 20 years as a vascular surgeon at St Mary’s Hospital. In 1993, she became the first female professor of surgery in the UK and used her profile to encourage more women to join the profession. She served on the council of the Royal College of Surgeons and later as its vice president. She also served as president of the Vascular Surgical Society and the Association of Surgeons of Great Britain and Ireland and, in 1999 was awarded a CBE for services to surgery and women in medicine. In May 2018, she was given an NHS Heroes Award. Professor Mansfield talks to us about her career highlights, being a role model and how her specialty has changed over the years.
I qualified as a doctor in Liverpool in 1960 and trained as a general surgeon. I always wanted to be a surgeon. In my mind surgery is the most complete medical practice – you talk to the patient, order or perform investigations, make a diagnosis and then operate. As a surgeon, the treatment is quite literally in your hands. I never had any doubts about it, and I thoroughly enjoyed my 40-year career.
Vascular surgery was fairly new when I trained in the sixties but when I watched an operation on an aortic aneurysm, I was captivated by it. I took every opportunity to develop in this area and by the time I became a consultant in 1972, I was a trained vascular and general surgeon. I did both for many years and started work at St Mary’s Hospital in the early 1980s.
Women in surgery
In 1993, I was appointed professor of surgery at St Mary’s Hospital and became the UK’s first female professor of surgery. Female surgeons were rare throughout much of my career but I found that if you’re doing a job and you’re doing it well, people are not concerned whether you’re a man or a woman.
I started the Women in Surgical Training initiative at the Royal College of Surgeons to encourage and support more women who wished to pursue the specialty. I was astonished at how many women turned up for the first meeting. It became obvious that, even at that stage, lots of women were thinking about becoming surgeons but were put off from actually doing it because they thought it just wasn’t possible. I’m pleased to see how far we’ve come now – it’s no longer cause for comment if you’re a surgeon who is a woman.
Progress in the specialty
Anaesthesia has improved in leaps and bounds during my time as a surgeon. When I started in 1960, anaesthesia was not nearly as sophisticated as it is now and there was no such thing as an intensive care unit. The anaesthetist keeps the patient alive while we surgeons carry out major and, sometimes, quite hazardous procedures. They have the knowledge and skills to maintain the integrity of a patient’s cardiovascular system during the course of the procedure. As surgeons we depend on the anaesthetist and it’s very much a partnership. I’ve worked with some wonderful anaesthetists and I’ve always been grateful for how they ensure patients are well looked after.
Imaging has changed beyond all recognition since I first became a surgeon. I’ve lived through the advent of ultrasound, CT and MRI scanning – none of them existed when I qualified as a doctor. All of these things have made diagnosis more reliable and considerably easier and also help us plan for surgery. In one of my earliest aortic aneurysms, one of the patient’s kidneys was down in their pelvis which meant that the blood supply to the kidney was going to be cut off when I did the operation. It was perfectly feasible to proceed, and I successfully completed the operation, but today surgeons know things like that ahead of time and can make arrangements to ensure the procedure goes smoothly.
I’m often asked to predict how surgery might change in the future but I’m reluctant to give an answer. Generally speaking, when we try to predict the future, we get it wrong! And when I think back about how much vascular surgery has changed in just the last 20 years, it’s clear I can’t possibly predict where we’re going next. Much of vascular surgery is now done via a catheter in an artery rather than making a large incision in the patient’s body. The development of minimally invasive surgery has been nothing short of amazing.
Life after retirement
After I retired in 2003, I took on the chairmanship of the Stroke Association for five years which was a wonderful experience. I went all over the country and really enjoyed watching the average person’s knowledge of stroke develop from almost complete ignorance to quite a sophisticated understanding. I then spent one year as the BMA’s president and another five years as the chairman of the BMA’s board of science in addition to a number of other charitable roles.
Perhaps most exciting of all: I learned to play the cello! I’m a good pianist and have been for quite a part of my life but I’d always wanted to play in an orchestra, so I thought I’d take up the cello. I wouldn’t say I’m a cellist at all but I play it sufficiently well to enjoy it, to play with other people, and to play in an orchestra. I play with two amateur orchestras and they give me a great deal of pleasure. It’s a lovely thing to do at the age of 80!
Advice for young surgeons
I think the most important thing for young surgeons to establish is whether this is the career they really want. It’s not easy – students don’t always have enough time in each specialty that they are exposed to and once you commit to a specialty, you’re in that job for 40 years plus. No matter how much we talk about hours of work and managing training, surgery is a very demanding branch of the profession – you cannot walk away in the middle of something, you have to see it through. It’s important to make sure this is what you really want for your life.
The second thing is to remain focused on that which is most important to you at every stage in your career, particularly if you take on something academic. There will be many demands on your time and it’s very easy to become distracted from what you’re supposed to be doing. But if you really want to do it, go for it. You can do it!