In a rich qualitative analysis of interviews with women who left surgical training in Australia, Rhea Liang and colleagues report in The Lancet their study that applied insights from feminist and social theories to illuminate how various factors interact to disadvantage women. They persuasively argue that various stresses accumulate like a tower of stacked blocks. Eventually, an individual's tower can reach a height that it will topple in the absence of efforts to stabilise it; often the final toppling precipitator appears relatively minor. Their findings suggest that interventions seeking to improve retention and advancement of women in surgery must address the underlying multiple and constituent factors (blocks) rather than narrowly focus on the ultimate triggers. Ideally, such interventions should not overtly focus on women alone.