Throughout the United States, there have been recent reports of high-profile sexual harassment cases in academic medicine, suggesting that these events still occur despite increased vigilance about the problem. Few studies have examined how many women in the modern era have directly experienced sexual harassment in medicine. The current literature is largely outdated and the more recent investigations have focused mostly on medical trainees and single specialties or have been conducted in settings outside of the U.S.
“In a study published in 1995, researchers found that about 52% of U.S. academic medical faculty women reported being harassed or discriminated against at some point during their careers,” says Reshma Jagsi, MD, DPhil. “These women began their careers at a time when women constituted a minority of the medical school class. Since that time, much has changed, with the number of women and men in medical school evening out in recent years. However, due to a lack of more recent data, little is known about the prevalence of discriminatory and harassment experiences among younger faculty groups.”
Surveying the Scene
Dr. Jagsi, MD and colleagues sought to address this research gap when they published a research letter in JAMA that surveyed more than 1,000 men and women in medicine who earned a career development award from the NIH between 2006 and 2009. In 2014, the authors surveyed recipients of the award, which is presented to clinician-researchers who have demonstrated the potential to advance their career as independent researchers. “The survey was given at a time when these physicians were mid-career,” says Dr. Jagsi, “and the average age of the participants was 43.”
For the survey, participants were asked about their experiences as a doctor, including any gender bias or sexual harassment they suffered during their career. Additionally, those who had experienced sexual harassment in their professional careers were asked to report their perceived effects on confidence and career advancement. Participants were also asked to specify the severity of the experience using five levels:
- Level 1: Generalized sexist remarks and behavior.
- Level 2: Inappropriate sexual advances.
- Level 3: Subtle bribery to engage in sexual behavior.
- Level 4: Threats to engage in sexual behavior.
- Level 5: Coercive advances.
The study group noted that these items are commonly administered in national studies of sexual harassment.
According to the findings in this great post to read, women were more likely than men to report perceptions and experience of gender bias in their careers (Table below). About 70% of women surveyed perceived gender bias, while 66% reported that they had experienced it. On the other hand, only 22% of men perceived gender bias and just 10% reported experiencing it.
“Women were much more likely than men to report having personally experienced sexual harassment by a superior or colleague,” says Dr. Jagsi. “About 30% of women reported having experienced sexual harassment, compared with just 4% of men. This difference is large given that the women began their careers after the proportion of female medical students exceeded 40%.”
The study also revealed that about 40% of women who reported being harassed described experiencing more severe forms of harassment, and 59% perceived that these events had a negative effect on their self-confidence as professionals. Another 47% reported that these experiences negatively affected their career advancement.
A Sobering Reminder
Recent data show that women account for about half of all medical students today. “Awareness about unconscious gender bias and openly inappropriate sexual harassment behaviors is essential,” Dr. Jagsi says. “Our findings are a sobering reminder that while society has come a long way, there are still many miles to go before we truly achieve gender equity. Many clinicians today believe that behaviors like harassment and discrimination against women are a thing of the past, but our data contradict this notion.”
Dr. Jagsi says physicians should recognize the degree to which sexual harassment and gender inequality continue to be an issue in academic medicine. “We need to recognize the impact of sexual harassment because perceptions that such experiences are rare may in fact increase stigmatization and discourage reporting. Women who experience it may be less likely to report such incidents if they feel they are unique and aberrational. It’s important to shed light on this issue so that female physicians don’t blame themselves by thinking they brought discrimination or harassment upon themselves. This is a larger societal problem. We need to develop interventions that transform the culture to mitigate the effects of subtle forms of bias and also to eliminate more overtly inappropriate behaviors.”
Reshma Jagsi, MD, DPhil, has indicated to Physician’s Weekly that she has or has had no financial interests to report.
Readings & Resources (click to view)
Jagsi R, Griffith KA, Jones R, Perumalswami CR, Ubel P, Stewart A. Sexual harassment and discrimination experiences of academic medical faculty. JAMA. 2016;315:2120-2121. Available at: http://jama.jamanetwork.com/article.aspx?articleid=2521958.
Fnais N, Soobiah C, Chen MH, et al. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med. 2014;89:817-827.
Carr PL, Ash AS, Friedman RH, et al. Faculty perceptions of gender discrimination and sexual harassment in academic medicine. Ann Intern Med. 2000;132:889-896.
Jagsi R, Motomura AR, Griffith KA, Rangarajan S, Ubel PA. Sex differences in attainment of independent funding by career development awardees. Ann Intern Med. 2009;151:804-811.