Sexual discrimination and harassment affects career
choices
Irina Haivas, Freiburg
Exposure to sexual discrimination and sexual harassment
in medical school influences students' choice of specialty and later
their residency programme ranking, especially for women (Academic Medicine 2005;80:400-8).
Terry Stratton and colleagues analysed responses from 1314 students in US
medical schools and found that 93% of women and 83% of men experienced,
observed, or heard about such incidents during medical school. For a high
percentage of women (45%) compared with men (16%), exposure to
discrimination and harassment influenced choice of specialty.
"Gender discrimination and sexual harassment are
important aspects of negative environments," Dr Stratton explained.
"Since much medical training occurs via mentoring, role modelling,
and direct experience, students should be aware that not all behaviours
they observe in superiors, peers, or patients are professional, proper, or
even legal. Training institutions, too, need to recognise that academic or
professional freedoms do not extend to discrimination and harassment based
on gender - and that a lack of awareness on the part of perpetrators
may be a contributing factor."
SUNSET/REX
The study also showed that the situation varies across
specialties. Incidents were more likely to occur in obstetrics and
gynaecology (42%), general surgery (20%), emergency medicine (19%), and
paediatrics (19%). Women are more affected across all specialties, except
for obstetrics and gynaecology, for which more men reported exposure.
"All specialties should care about this, but specialties that have a
substantial problem - surgery and obstetrics-gynaecology, in our
case - should be especially attentive. Such specialties in which
discriminatory or harassing behaviours have over time become deeply
ingrained in the ‘hidden curricula' of their disciplinary
training may be in most obvious need of remediation; ironically, this may
also render them most impervious to change," said Dr Stratton.
Students are generally aware of these issues.
"Like patients, US medical students are more consumerist oriented,
better educated with regard to the profession of medicine, and likely to
have formed opinions about what is right and wrong. However, students may
also be uncertain how to deal with discrimination and harassment in medical
training environments," said Dr Stratton.
"Some research outside the United States suggests
that medical student mistreatment knows no boundaries," said Dr
Stratton. However, core behaviours that would be universally construed as
sexual discrimination and sexual harassment are not yet clearly identified
and defined. "Cultural, structural and other contextual factors would
all influence, to some degree, the meanings that individual students might
assign to identical behaviours - as well as how institutions might
subsequently choose to respond."
studentBMJ 2005;13:221-264 June ISSN 0966-6494
