A macho culture among surgeons is turning female medical students away from the profession, experts are warning.

Only 10 per cent of surgeons in Britain are female, thanks to negative media stereotypes and a well-deserved reputation for sexual discrimination.

Fiona MacNeill, who tutors at the Royal College of Surgeons, says surgery is the last bastion of sexism in medicine. 'It is the field that is seen as the most macho in the whole area of medicine and that reputation is actively encouraged by the men currently presiding over it,' she said. 'There is a very strong boys' club culture that makes women feel very excluded.

'The stereotype on the television of the arrogant, distanced, white, middle-class surgeon is widespread and very powerful in implanting a negative assumption in women's minds,' added MacNeill, a leading breast surgeon based at Ipswich Hospital.

'At medical school, when the female students see the old school surgeons who conform to that stereotype and get a taste of the world they inhabit - with its ridiculous working hours and oppressive assumptions and atmosphere - they're put off for good,' she said.

Although women account for 70 per cent of students at many medical schools, the majority will not even consider surgery as a career.

'It is enormously damaging to the whole medical field if those who put themselves forward to become surgeons are only coming from a pool of 30 per cent of all students,' said MacNeill. 'That is no way to ensure that the best students are entering the field.'

MacNeill believes there is an ethical necessity to encourage more women to become surgeons. 'Women are better communicators, they work better in a team and are more sensitive to patients,' she said. 'There is no doubt that the profession suffers without a female presence.'

But although things are slowly changing, the battle is a difficult one to fight, says MacNeill.

'The sexism is very subtle because you're dealing with very intelligent, elite men who won't be caught out discriminating in a way that can be openly tackled.

'But there is a definite, albeit a very subtle, feeling that women aren't quite up to the job and that they're resented for changing the atmosphere by diluting the male environment with their presence.'

The Government is so concerned by the issue that steps are being taken to confront it, including an attempt by the Department of Health to overhaul the inflexible and arduous training process. The drive, Modernising Medical Careers, which is to be introduced in August 2005, will shorten the course from 15 years to eight.

But even after qualification, working patterns are a problem, with many surgeons regularly working more than 100 hours a week.

'If you take time off from that schedule, you're considered to have failed in the field and that, obviously, is a culture that is intolerable for women who want to take time off to have a family at some point,' said MacNeill.

Finola Lynch, a second- year medical student at the University of East Anglia (UEA) and a member of the Medical Women's Federation, was one of the many who immediately dismissed the idea of becoming a surgeon. 'The whole image of surgery is of a male-orientated career where women are secondary members of the team, there to support one individual: the central male,' she said.

'The atmosphere created in theatre by the gender bias is generally assumed by female students to be aggressive and intimidating,' she added. 'It doesn't help that whenever you see surgeons on the television, the presence of a woman is an exception.

'Without realising it, I had closed my mind to surgery. I never seriously considered it for a moment as a career for me,' she said.

Lynch believes that although inroads are being made, it will take another 20 to 30 years before a difference is really seen. 'Things are changing but not fast enough for my liking,' she said.

Linda de Cossart, a member of the Royal College of Surgeons council, has been a surgeon for 32 years and a consultant for the past 16.

When she first joined the Countess of Chester Hospital, there were four surgical consultants, one of whom was female. Now, however, there are eight consultants, with three women.

'Surgery is a totally male-dominated field,' she said. 'But over the last decade, it has begun to change for the better.' Cossart, who was director of surgical training at the Merseyside Deanery for 11 years, believes it is perfectly feasible for women to have a family and continue their training.

'Of my 40 trainees, 30 per cent were women, most of whom had babies during training and every single one of whom returned to their training,' she said. 'We have proved it can be done, albeit with a lot of effort from all those involved.'