A Sydney senior surgeon whose comments on sexual harassment helped draw attention to widespread bullying in the profession has warned that it will be difficult to fix the problem.

Vascular surgeon Gabrielle McMullin said "a small group of very powerful men at the top" were responsible for fostering a bullying culture among surgeons and would be "rolling their eyes at the report".

The Australasian College of Surgeons-commissioned report published on Thursday revealed a toxic culture in operating theatres throughout the country, in which bullying was endemic and victims feared reporting it would be "career suicide".

While she praised the report and the college's apology to victims, Dr McMullin feared this group would "remain untouchable" and it would take a strong commitment to overturn the practice of "education through humiliation" and make the profession more welcoming to women and international graduates.

Dr McMullin made headlines in March when she said female surgical trainees could see their careers destroyed by reporting sexual harassment. She had pointed to the case of Caroline Tan, a neurosurgeon who was found to have been assaulted by her supervisor but had failed to find work in the public hospital system.

"Since my original remarks many surgeons have denied there is a problem and others have suggested that in their speciality there is not a problem," she said. "This report clearly shows there is an enormous problem across all specialties and senior surgeons are the primary source."

The report found almost half of the 3500 surgeons and surgical trainees surveyed had experienced some form of bullying, harassment or discrimination.

It said the culture in surgery needed to change, that surgeons had to find better ways of providing feedback to trainees, and for complaints to be better handled so those who were bullied did not feel afraid to come forward

Australian Medical Association president Brian Owler said it would be up to the current generation of surgeons to "break the cycle" of bullying, harassment and discrimination in the profession.

"We need to be the first generation that does not perpetuate this culture of bullying and that we ensure that we look after our colleagues," he said.

St Vincent's Health chief medical officer Victoria Atkinson said the report's findings were a "wake-up call" to the health sector.

She said St Vincent's, which operates 12 hospitals nationwide, would work with the college on fighting bullying.

"Many surgeons are far more concerned about college accountability and the threat to fellowship than a formal warning from a hospital," Dr Atkinson said.

Australian Nursing and Midwifery Federation federal secretary Lee Thomas said nurses were also exposed to bullying and were sometimes too scared or embarrassed to come forward.

She welcomed the report as a "first-step in acknowledging the issue of bullying and then moving to a system where nurses, midwives and other health professionals are protected in the workplace"

Some surgeons took to Twitter on Thursday to give their reactions to the report, calling it "shocking beyond belief".

Past formula for experiencing no bullying/harassment in surgery:- 1. White 2. Male 3. Private school network 4. Love rugby 5. Father surgeon— Henry Woo (@DrHWoo) September 9, 2015

This is shocking beyond belief. Shame on the perpetrators. And those who stood silently by. http://t.co/iRdhvK57TJ— John McGarva (@IamChirurgicus) September 9, 2015

The Surgeons at @RACSurgeons are getting their house in order. I hope other houses are following suit. https://t.co/yKtzAKuw9R— Dr Eric Levi (@DrEricLevi) September 9, 2015

First 3 words a surgeon spoke to me when I started work as a surgical house officer: "You stupid woman" That ruled that out as a specialty.— Marie Bismark (@mbismark) September 9, 2015

The New Yorker's medical writer and Harvard surgery professor Atul Gawande called the findings "horrific":

Horrific. Aussie report finds female surgeons coerced to give sexual favors (@theage). Am I naive to think: not here? http://t.co/QAoNtDAru4— Atul Gawande (@Atul_Gawande) September 9, 2015