Island Med Student

Surgeon: “Would you like to close up the incision?”

Medical Student: “Yes, definitely!” (Student begins suturing.)

Surgeon: “Wow, you certainly are good with your hands! I wonder if you’re as good with them in the bedroom as you are in the OR!”

Does this exchange sound somewhat familiar to you? If you’ve ever been inside an operating room, the chances are that it does. Whether or not it was directed towards you, it is very likely that you’ve heard a similar conversation occur.

Would you consider this to be sexual harassment, or simply a playful joke? Perhaps most of you would agree that it does represent unprofessional behavior. But if you were the medical student in this scenario, would you choose to report these comments by your resident or attending surgeon? The statistics predict that you probably wouldn’t.

The prevalence of sexual harassment during medical education has been well documented over the past twenty years. In 1993, a study in the New England Journal of Medicine attempted to determine the prevalence of sexual harassment, and whether it is adequately addressed by training institutions. Another 1993 study published in the Journal, Academic Medicine, attempted to classify the perceptions of sexual harassment by students and residents. Numerous other studies have documented the prevalence of sexual harassment in medical school and residency and have focused on aspects such as how to distinguish it from gender discrimination, how it ultimately effects specialty or residency program choice, and methods of eradicating it from medical education.

The U.S. Equal Employment Opportunity Commission (EEOC) states that sexual harassment occurs, “when submission to or rejection of this conduct explicitly or implicitly affects an individual’s employment, unreasonably interferes with an individual’s work performance or creates an intimidating, hostile or offensive work environment.” Some examples used by different studies include: repeated comments about one’s anatomy; repeated jokes or remarks that are stereotypical or derogatory to members of one sex; persistent, unwelcome flirtation; expressions of sexual interest; displays of offensive sexual pictures; unwelcome comments on the student’s dress; standing too close; unwelcome touching; and offers of a better grade in exchange for sexual favors.

I am going to come right out and admit that I have both witnessed and been on the receiving end of sexual harassment during my clinical rotations. Actually, I have seen or heard stories of every single one of the above examples occurring during medical training. I may represent an N of only one, but from the studies I’ve read, I am far from alone in my experiences. While I’ve observed, or been the “victim” of many different instances of sexual harassment, I’ve never formally reported any of it. I’m actually a bit disgusted at myself to admit this. If I had witnessed a patient being abused, or another serious infraction, I would likely have reported it. However, when it comes to sexual harassment, the general consensus seems to be that saying nothing is probably your “best bet.”

Many people fear the consequences of reporting sexual harassment. Will I be viewed as weak? If I defy a superior, will it affect my grade or status? Doesn’t sexual harassment just come with the territory? These are all questions that I think people ask themselves when they perceive that sexual harassment has taken place.

Have you ever witnessed or been on the receiving end of sexual harassment in medical training? Did you decide to report it? Do you think it’s a significant problem in our medical schools and hospitals? I encourage you to share your stories.

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