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It is a fact that, despite the worldwide increasing intake of women in medical schools, women are still grossly underrepresented in all medical and surgical specialities, and definitely in cardiothoracic surgery in both developed and developing countries. This is counter-productive towards meeting the escalating need for cardiac surgical care in Africa. However, the natural evolution over time of increasing numbers of females entering medical school and specializing in the field of surgery, is expected to continue despite multiple challenges encountered on their way. The inequities of healthcare provision in Africa in particular needs the continual support of all professionals that are able to contribute to the wellbeing of those innocent individuals that need medical care particularly children born with congenital cardiac defects. In addition to factors on the African continent, realities and challenges for future female cardiothoracic surgeons include gender bias and gender-based discrimination by some male counterparts. The question must be asked: "Is it mere gender-based discrimination, or how much does deliberate 'bullying behaviour' mimic signs of superiority, arrogance and entitlement, bordering on psychological personality disorders?" Thorough investigation of the possible role of such behaviour disorders in gender bias and discrimination is long overdue. These disparities and challenges should be actively addressed on all levels by all role players by placing more emphasis on merit, competence and surgical outcomes than on the gender of the surgeon. Despite all these challenges, the benefits of a career in cardiothoracic surgery and tremendous job satisfaction far exceed the disadvantages.

Realities and challenges for female cardiothoracic surgeons: an African perspective