Only four out of every hundred surgeons in Britain's hospitals are women, according to the latest NHS figures. Ann James, one of the minority, explains why
got my first introduction to male attitudes in this profession when I was a Senior House Officer training to be a surgeon. Our boss called all the housemen and senior housemen together one morning - for some of them it was their first day - and said that the boys were going to get on all right because they could bonk the nurses on the ward, but he wasn't sure how the girls would manage. The same surgeon asked me at an interview whether I thought I was at a biological disadvantage being a woman - so I said I thought he was.

I always wanted to be a surgeon. My best friend's mother said I was very good at needlework when I was young, but the funny thing is that actually I wasn't. Although I've experienced some prejudice myself I have probably had it easy compared to the girls who didn't make it.

People have certain views about women being surgeons, but male bravado isn't all you need. It's about sensitivity and dexterity. My day starts at 8am with a ward-round which lasts half an hour, then I'm into theatre: I've worked 27-hour stints, without a break, two or three times. That's 27 hours physically standing at the table and operating. I don't find the blood a problem. Blood's clean. But I have had some quite disturbing cases, such as the night I dealt with a stabbing. The patient was an air hostess who had been stabbed 28 times by her ex-boyfriend ... but she made it.

The main thing that upsets me is the children. Just after I had my daughter (who was two on Friday), I was dealing with a baby about four weeks old. I was very upset in front of the mother after the operation, and I think she was a bit concerned. People think as professionals we shouldn't get emotional like that.

Most of my problems with male attitudes started when I got pregnant. There's still a lot of antipathy among the men about maternity leave. One of my colleagues said he wasn't going to employ any more women surgeons because they kept getting pregnant. Everybody in surgery wants to be thought of as pulling their weight and not letting the side down.

I was perceived as not being committed because I was having a baby. When I was heavily pregnant I got comments from male colleagues who said I was finding it difficult to get close to the operating table. So I pointed out my belly was no bigger than some of theirs... One reason why women don't go into surgery is that you tend to move around a lot from one end of the country to the other. I qualified in London and I've worked in Wales and Kent, as well as various London hospitals. While most male surgeons have wives who are willing to follow them around the country with their jobs, fewer husbands will follow their wives. My husband works in the City, so for a long time we commuted between each other along the M4.

I feel I'm one of the lucky women in surgery because I have managed to have a successful career and a family life. I think some women surgeons miss out on that social side of life which is a great shame. Also, there are certain specialities within surgery that I wouldn't go into because they are so male-dominated. Orthopaedics for example, because there's a lot of chopping and sawing of bones. The men like it because it reminds them of their Meccano kits.

But things are improving. Often the operating theatre is full of nurses and sometimes we can have an all-girlie theatre. That always arouses a few comments - but usually nice ones.

8 Ann James is a pseudonym