In 2018, the medical and scientific communities were rocked by revelations of widespread sexual harassment of women, as described in a groundbreaking report from the National Academies of Science, Engineering, and Medicine (NASEM), Sexual Harassment of Women: Climate, Culture and Consequences in Academic Science, Engineering and Medicine.
Not much has changed in the five years since.
That’s the finding of a new AAMC report released on July 26: Understanding and tackling sexual harassment in academic medicine. Using data from the AAMC StandPoint™ Faculty Engagement Survey, collected between 2019 and 2021, the report found that 34% of female teachers and 22% of teachers in general have experienced sexual harassment.
The highest rates of harassment among female faculty were in departments of anesthesiology and emergency medicine, each at 52.6%. The lowest rates were in urology and radiology, at 20.7% and 21.6%, respectively. The Faculty of Pharmacology reported the largest gender differences in harassment experiences: 7.6% of men and 47.7% of women.
Even among the departments with the highest percentage of female faculty according to the AAMC faculty roster — OB-GYN and pediatrics — the harassment rates reported by women were comparable to the overall average of 34%.
Faculty experiences with sexual harassment
Sexual harassment can be divided into three categories: sexual harassment, unwanted sexual attention and sexual coercion. This report focuses on cases of gender harassment, defined as “verbal and non-verbal behavior that conveys hostility, objectification, exclusion, or second-class status toward members of one sex.”
Specifically, the survey participants were asked about five behaviors and how often they experienced them.
- Tell sexist stories or jokes that were offensive to you (19.7% of women, 9.6% of men)
- Make abusive comments about your appearance, body, or sexual activity (7.4% of women, 3.0% of men)
- Refer to people of your gender in abusive, insulting or vulgar terms (12.0% of women, 3.6% of men)
- Putting you down or condescending because of your gender (24.0% of women, 2.8% of men)
- Send offensive messages based on your gender or show you obscene images (1.4% of women, 0.8% of men)
Certainly, the consequences of any form of harassment are significant.
Faculties that experienced harassment were generally less knowledgeable about how to report it, felt less safe to report it, and were less confident that their institution would resolve their complaints than those who were not harassed, according to the survey.
Even more worryingly, teachers who experienced harassment were less engaged, less satisfied with their medical school as a place to work, and less likely to remain in their facility than their peers who did not report experiencing harassment.
While it is a fact that women are predominantly the target of sexual harassment, including gender, harassment, men also experience harassment. Therefore, a binary approach to harassment — men as perpetrators, women as victims — ignores the many types and identities of people who experience harassment, as well as how other behaviors, such as bullying, contribute to an overall culture of harassment.
Institutional Strategies
In academic medicine, multiple efforts are made to address and prevent sexual harassment. Several institutions, identified through the NASEM Action Collaborative of institutions actively involved in this field, were interviewed for the AAMC report to identify innovative practices.
For example, the Ohio State University College of Medicine has instituted a pre-hire faculty misconduct screening, requiring all prospective candidates to sign an authorization form that allows the college to contact current and former employers about any investigation of misconduct. Similarly, the University of Wisconsin School of Medicine and Public Health uses a background investigation called Stop Passing the Harasser to address the practice of faculty and staff who leave an institution after being found responsible for harassment or during a harassment investigation.
At the Mayo Clinic College of Medicine and Science, each report of sexual harassment is assigned to one of the college’s 100 internally trained professional investigators. Once a study is complete, the investigator meets with the staff committee and department leadership to decide next steps, according to the Mayo Clinic Fair and Just Culture Framework, which outlines potential consequences ranging from conversation to termination. This process has served as a model for several other medical schools.
Multiple schools, including the University of Michigan Medical School, University of New Mexico School of Medicine, Wake Forest University School of Medicine, and University of Virginia School of Medicine, provide robust resources for reporting harassment. Several schools, including Mayo and the University of New Mexico, are also informing their communities about the types of reported harassment and the measures taken to address it. This helps create a culture of anti-harassment and raises awareness about the institution’s commitment to addressing harassment.
Finally, many schools offer training beyond what is required by state and federal mandates. For example, the Columbia University Vagelos College of Physicians and Surgeons provides training with content on protected classes, affirmative action law, relationship policies, and the types of behaviors that should (or should not) be reported.
Preventing Harassment
These institutional efforts to identify and address harassment are critical. So are innovative approaches to creating safe and inclusive environments.
Preventing sexual harassment starts with addressing the less overt but still harmful behaviors, such as patronizing language and comments about appearance, which in turn set the foundation and tone for creating a safe and inclusive environment. When institutions target these less overt behaviors and comments and address them directly and early, they can create cultures of responsibility that build trust, engagement, and ultimately greater support for all in academic medicine.
Diana Lautenberger is AAMC Director of Gender Equity Initiatives. Valerie Dandar is AAMC Director of Medical School Operations. They co-authored the report with You Zhou, a doctoral student at the University of Minnesota.