The objective of this study was to identify some of the reasons why women reject surgical careers, and to suggest actions which might reverse that trend. The subjects were new entrants to medical school, third-year medical students and pre-registration house officers (PRHOs) at the Medical School of Newcastle-upon-Tyne. A cross-sectional descriptive survey, using a self-administered questionnaire. Of 247 females surveyed, 99 (40%) had rejected surgical careers, mainly because of 'personal preference'. Women saw such careers as unfavourable to them, largely because of a perception of male bias. No more than 10% of females in each subject group had surgical role-models. The perceived quality of teaching and friendliness of consultants had a significant influence on career decisions. Women reject surgical careers because of perceptions of 'male bias' and 'negative attitudes'. An increase in the number of surgical role models among women could improve this situation, as could apparent enthusiasm for teaching and enjoyment of their specialty by consultants.