Nearly one-third of high-achieving female physician–scientists reported experiencing sexual harassment during their careers, according to survey results published online today in JAMA.
Although the percentage has declined considerably over the past 20 years, the findings suggest additional efforts are needed to eliminate both unconscious bias and more overtly inappropriate behaviors in the workplace, Reshma Jagsi, MD, DPhil, associate professor and deputy chair of radiation oncology at University of Michigan Medical School, and colleagues concluded.
“Even in a modern academic cohort of medical faculty, experiences with sexual harassment and discrimination are not uncommon, and they are more frequent among women,” Jagsi told HemOnc Today. “I do not think this is a castigation of academic medicine specifically. It is a sobering reminder of how far we have to go as a society. This is a broader issue.”
A cross-sectional survey of U.S. academic medical faculty in 1995 showed 52% of women and 5% of men reported experiencing sexual harassment during their careers. Participants in that survey began their careers at a time when men comprised a much greater percentage of medical school students than women.
Jagsi and colleagues conducted their study to assess the prevalence of sexual harassment among a more recent cohort of faculty who started their careers at a time when women accounted for more than 40% of medical students.
“I quite honestly was looking for good news,” Jagsi said. “I thought we were going to find that overt discrimination would be much less common now that women were so much better represented among medical students and were starting to be better represented among faculty cohorts.”
The researchers conducted a postal survey in 2014 of physician–scientists who received career development awards from the NIH between 2006 and 2009.
The survey designed to gauge respondents’ career and personal experiences included questions about gender bias, gender advantage and sexual harassment.
Those who indicated they experienced sexual harassment in their careers were asked to report how it affected their confidence and career advancement, as well as to describe the nature of the experience by choosing one of five categories: generalized sexist behavior or remarks; inappropriate sexual advances, subtle bribery to engage in sexual behavior; threats to engage in sexual behavior; or coercive advances.
Researchers sent the survey to 1,719 physician–scientists, 1,066 (62%) of whom responded. The majority of survey respondents were men (54%) and white (71%). Mean age of respondents was 43 years (standard deviation, 4.3).
A significantly higher percentage of women reported perceptions of gender bias (70% vs. 22%; difference, 48%; 95% CI, 43-53) and experience with gender bias (66% vs. 10%; difference, 57%; 95% CI, 52-62).
Women also were significantly more likely than men to report experiencing sexual harassment (30% vs. 4%; difference, 26%; 95% CI, 22-31).
Of the 150 women who reported harassment, nearly all (92%) indicated they experienced sexist remarks or behavior; 41.3% indicated they were subjected to unwanted sexual advances; 9.3% reported coercive advances; 6% reported subtle bribery to engage in sexual behavior; and 1.3% indicated they received threats to engage in sexual behavior.
More than half (59%) of those who reported harassment perceived a negative effect on their professional confidence, and 47% indicated the experiences negatively affected their career advancement.
“Recognizing that these experiences are not uncommon is important to inform policy, as well as to let women know that if they have an experience like this, it is not rare or aberrational,” Jagsi said. “I think there is this false perception among many men and women alike that these kinds of experiences are very rare, and this might make women blame themselves or impede reporting and solicitation of help when something like this does happen.”
Researchers acknowledged nonresponse bias as a potential study limitation. Those who experienced harassment may have been more motivated to respond, potentially inflating estimates. However, the investigators placed those questions at the end of the 12-page questionnaire to minimize this risk.
Interventions designed to help ensure gender equity in the medical community are being developed at various institutions, and studies of their effectiveness will be important, Jagsi said.
“It is only through active intervention and promotion of culture change that we will really see a change in these types of experiences,” Jagsi said. “We need careful, meticulous and rigorous research to identify what components of interventions to promote cultural transformation are effective. It is like any other form of evidence-based research that we as oncologists know how to evaluate.” – by Jennifer Southall
For more information:
Reshma Jagsi, MD, DPhil, can be reached at firstname.lastname@example.org.
Disclosure: The researchers report no relevant financial disclosures.