Let's Remove It

Bullying, undermining and harassment have no place in surgery. The Royal College of Surgeons of Edinburgh’s Let’s Remove It resource hub supports surgeons, trainees and healthcare professionals to recognise harmful behaviours, understand professional standards, access support and help create a safer, more respectful workplace.

Surgery is a valuable and rewarding career. The majority of surgical professionals enjoy this challenging but intensely satisfying profession. Indeed, the high numbers of medical graduates who apply for surgical training - more than the actual spaces available to them - indicates how popular surgery remains as a career.

However, according to the 2025 GMC National Training Survey, a fifth of doctors training in surgery posts said that staff are not always treated fairly. 22% of female and 18% of male resident doctors in surgery experienced intentional humiliation.

A quarter of female and 16% of male resident doctors in surgery also reported being ignored or excluded from conversations, groups, or meetings. In addition, 41% of female resident doctors in surgery reported hearing insults, stereotyping or jokes about a protected characteristic, such as age, race, sex, gender reassignment, disability, sexual orientation, religion or belief, marital status, and pregnancy/maternity. 14% of female resident doctors in surgery also experienced unwelcome sexual comments or advances that caused them embarrassment, distress, or offence. This compares to 3% of female GP trainees.

Surgical groups have reported similar findings. For example, a survey of UK resident doctors in Vascular surgery conducted by the Rouleaux Club in 2021 found that 72.2% of respondents personally experienced bullying, undermining or harassment and 57.7% had witnessed it. In response, Rouleaux Club stated that such "behaviours are an ongoing problem within UK vascular training."

The causes of bullying are structural and cultural, and we acknowledge that factors such as heavy workloads, personal responsibility, the intensive nature of surgical training and work-life imbalances can all create their own significant pressures.

Nonetheless, we are clear that bullying, undermining, and harassment are unacceptable in any and every form. This is because these oppressive behaviours not only have devastating impacts on the individuals affected but also has profound consequences for patient care.

Bullying, undermining, and harassment drain valuable NHS resources, costing the NHS in England at least £2.3bn a year in terms of sickness absence, employee turnover, lost productivity, and employment relations costs.

Moreover, studies from the USA have attributed disruptive behaviour in the perioperative area alone to 67% of adverse events, 71% of medical errors, and 27% of perioperative deaths.

The Civility Saves Lives campaign reported that rudeness at work can lead to a 61% reduction in cognitive ability of the recipient of the rudeness and a 20% reduction in cognitive ability of all onlookers. This in turn leads to greater risk of human error as well as lower morale, reduced productivity and less effective teamworking.

Conversely, a 2026 study of NHS Trusts in England suggested that NHS Trusts with higher empathy ratings benefited financially and had improved staff wellbeing.

Bullying, undermining and harassment are contrary to the professional behaviours outlined in the General Medical Council's Good Medical Practice guidance and which apply to all doctors on the medical register with a licence to practise. Domain 3 (Colleagues, culture, and safety) clearly outlines the teamworking and interpersonal relationships expected, including the specific statement that one "must not abuse, discriminate against, bully, or harass anyone based on their personal characteristics, or for any other reason."

Similarly, members of the extended surgical team are expected to comply with the Nursing and Midwifery Council's Code of Practice that states one must "act with honesty and integrity at all times, treating people fairly and without discrimination, bullying or harassment".

The NHS Health and Wellbeing Framework sets out a number of standards for what NHS organisations in England need to do to support staff feeling well, healthy, and happy at work. This states that the NHS "must aim for a culture of civility and respect but we must also provide targeted support for those that are, or have experienced incivility, disrespect, bullying or harassment."

Bullying Harms Your Profession And Your Patients. #Let’sRemoveIt

Anti-Bullying and Undermining Resources