During training sessions, we are often asked whether there is a difference between men and women when it comes to safety. For a long time, I answered that it was difficult to draw conclusions, since most professions are predominantly occupied by one gender. That is now changing.
Oncologist Christopher Wallis from the University of Toronto explained to Scientias.nl that men and women are now more evenly represented among surgeons. When their performance was compared, the results were not favorable for men.
Female surgeons achieve better outcomes
The study examined 25 different surgical specialties, ranging from heart and kidney surgery to knee procedures. Operations of comparable complexity were compared. The findings are striking. Female surgeons not only have higher success rates (which was already known), but this advantage also extends to long-term outcomes. Up to one year after surgery, procedures performed by male surgeons show 6% to 8% more complications. Even more concerning is the difference in mortality rates: surgeries performed by male surgeons result in up to 25% higher mortality compared to those performed by their female colleagues. The underlying causes of this difference have not yet been studied.
No difference in knowledge or technical skill
It is important to state this clearly: the difference is not due to technical competence or intelligence. Both sexes are capable of performing at a very high level. The difference therefore does not lie in skill, but in its application—in the way work is organized and carried out.
The importance of communication and decision-making
The research shows that female surgeons spend more time with their patients on average. Their communication style is different—more empathetic—and they adhere more strictly to protocols and guidelines. These behaviors directly influence decision-making within the surgical team and demonstrably reduce the likelihood of errors.
Neuropsychology as an explanation
Beyond this study, similar differences are recognized outside the medical field. Neuropsychology teaches us that male and female brains do not differ significantly in intelligence. What does differ is that male brains tend to have more cells, while female brains have more connections between those cells. The key difference lies in how brain cells communicate. Female brains function more like a network, leading to more context-oriented thinking. Male brains tend to have a stronger focus on the goal. Put simply: male brains prioritize the essence and the objective, while female brains prioritize the consequence and the effect.
The parallel with safety science
And that is precisely where modern safety science places its emphasis: not only on the how of working safely—the rules—but also on the why and the broader context. First consult, then execute. First think, then act.
The practical lesson: A male professional—whether a surgeon, safety specialist, or team leader—can perform just as well, provided he takes the time to communicate effectively, align decisions, and take signals seriously. In other words, safety starts with insight and overview—and these are built together.
Source: Wallis, J.D. ea 2023 “Surgeon Sex and Long-Term Postoperative Outcomes Among Patients Undergoing Common Surgeries” – JAMA
Daalmans J.M.T., 2011, De Breingids, Boom