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Sexual Harassment in Medical Training


Sexual Harassment in Medical Training Vijay Rajput MD, FACP Program Director, Internal Medicine Associate Fellow at Center for bioethics at UPenn – PowerPoint PPT presentation

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Title: Sexual Harassment in Medical Training

Sexual Harassment in Medical Training
  • Vijay Rajput MD, FACP
  • Program Director, Internal Medicine
  • Associate Fellow at Center for bioethics at UPenn
  • Associate Professor of Medicine
  • Robert Wood Johnson Medical School

Sex At Work Right Or Wrong?
  • Make your own judgment?

"David Letterman Broke Two Cardinal Rules
Governing Workplace Romance."
Two never get involved with someone if you're
married or in a committed relationship.

  • workplace affairs are very common these days.
  • The best advice is not to get involved, but they
  • The best thing to do if you're going to go ahead,
    against all advice, and have a workplace affair,
    your best bet is to keep it very low-key.
  • Third cardinal rule Never have sex on company
    property. And that includes supply closets and
    copy rooms and stairwells and parking lots and,
    you know, all these adjacent areas.
  • Jennifer Kearns Lawyer on NPR

Relationship at work !!!!
  • The biggest problem in the workplace is when a
    relationship develops between a supervisor and
    his or her subordinate, because there is a
    disparity of power. And so even though the
    relationship may begin consensually, with both
    parties very interested in having a relationship,
    there is always the potential that the
    subordinate may later make a sexual harassment
    claim against the company, claiming that he or
    she was pressured into having that relationship.
  • Jennifer Kearns Lawyer on NPR

What about peer-peer relationship?
  • if you've got a reputation for sleeping your way
    to the top, even though that may not be the case,
    it's going to follow you.
  • People do gossip. Some people have very long
    memories, and some industries are very
    close-knit. And that reputation could follow you
    if you're a woman. Or if you're a man, you could
    get a reputation as a predator or as someone who
    preys on, you know, other employees.
  • Jennifer Kearns and Houston Lawyer and
    infidelity expert on NPR October 8, 2009

Other issues with peer-peer relationship
  • It is not lunch time or water fountain talk
  • Spend hours on email, face book and twitter
  • Decrease productivity

Jurors award Wal-Mart claimant 50 million
  • In 1995 Federal Court jurors awarded Peggy
    Kimzey, who sued Wal-Mart because of sexual
    harassment, 50 million in punitive damages.
  • Kimzey resigned from Wal-Mart in 1993, claiming
    an abusive and hostile work environment. Kimzey
    said her two supervisors constantly made
    derogatory remarks and company officials did not
    take action.
  • U.S. District Court Judge Scott Wright, however,
    lowered the award to 5 million, claiming the
    jury had awarded Kimzey too much money.
  • Kimzey vs. Wal-Mart Stores, Inc., 107 F3rd 568,
    573 (8th Cir 1997)

Astra to pay 10 million in sex case settlement
  • Lars Bildman, former Astra U.S.A. president and
    CEO, was accused of replacing older female
    employees and mothers with younger single women
    who were pressured into having sex with company
  • In a 1996 Federal lawsuit, six former Astra
    employees argued that executives had created "an
    organized pattern of sexual harassment" to
    "satisfy their personal desires," costing Astra
    nearly 10 million.
  • Settlement with EEOC by consent decree, 1998

Female professor awarded over 1 million
  • In 1990, Dr. Jean Jew, a female professor, was
    sexually harassed by colleagues after she
    received tenure at the University of Iowa.
  • She filed a lawsuit stating that the University
    was not responding promptly to her complaints.
    The university attempted, unsuccessfully, to
    argue that it was a case of freedom of speech
    rather than sexual harassment.
  • Dr. Jew was awarded a total of 1,070,000
    comprising 50,000 in back pay, 125,000 in
    damages, and 895,000 in fees and expenses after
    a lengthy five-year court battle.
  • Jew v. University of Iowa U.S. District Court

Predisposing factors
  • Long training and high stakes
  • Many supervisors and peers on each rotation in
    new environment
  • Long hours in small group
  • Emotionally taxing work
  • Breakdown of social barriers
  • intimate discussion of body parts

  • Quid pro quo Sexual Bribery
  • Another one is creating hostile, offensive, work
    environment, sexual advances and offensive

Response to harassment
  • 2/3 of women do not report the harassment to
    their superior.
  • They are not confident, whether they will be
  • Fear of retaliation
  • Fear of shame and guilt

Whose perspective is right one ?
  • It is interaction between two people.
  • Perception of the person harassed are often
    different from the person accused of being

  • Most of the time it judged by the perspective of
    reasonable women

Prior Studies
  • A large percentage of medical students (36 to 52
    percent) report experiencing some form of sexual
    harassment during medical school.
  • Women students being much more frequent than
    those by men.
  • Female physicians that included some residents
    reported that 27 percent had been sexually
    harassed in the preceding year.
  • None of these studies have examined the frequency
    and type of sexual harassment residents
    experience, the professional status of the
    harassers, the range of negative effects, or the
    likelihood that the harassment will be reported.
  • Mental health consequences and correlates of
    reported medical student abuse. JAMA
  • Student perceptions of mistreatment and
    harassment during medical school a survey of ten
    United States schools. West J Med
  • Perceived mistreatment and attitude change by
    graduating medical students a retrospective
    study. Med Educ 199125182-190.
  • The gender climate of medical school
    perspectives of women and men students. J Am Med
    Wom Assoc 198843109-10, 115.

Sexual Harassment in Medical Training
  • Background Sexual harassment has become a
    national concern and one that is increasingly
    recognized in the field of medicine. Although
    there are reports of the sexual harassment of
    medical trainees, there is little information on
    the prevalence of this problem and whether it is
    adequately addressed by training institutions.
  • Methods Surveys with descriptions and examples of
    sexual harassment were mailed to 133 internal
    medicine residents in a university training
    program. The residents were asked to report
    anonymously whether they had encountered sexual
    harassment during medical school or residency,
    the frequency and type of harassment, its effect
    on them, whether they chose to report it to a
    person in authority, and the factors that
    influenced this decision.
  • Results Surveys were returned by 82 residents
    (response rate, 62 percent) -- 33 women and 49
    men. Twenty-four women (73 percent) and 11 men
    (22 percent) reported that they had been sexually
    harassed at least once during their training. The
    women were more likely than the men to have been
    physically harassed, and the women's harassers
    were of higher professional status. Among those
    harassed, 19 of the women (79 percent) and 5 of
    the men (45 percent) thought that the experience
    created a hostile environment or interfered with
    their performance at work, but only 2 women and
    no men reported their experiences to an
    authority. The women cited a lack of confidence
    that they would be helped as the main reason for
    not reporting the experience, whereas men most
    commonly said that they had dealt with the
    problem without the need for outside assistance.
  • Conclusions Many medical trainees encounter what
    they believe to be sexual harassment during
    medical school or residency, and this often
    creates a hostile learning and work environment.
    Training institutions need to address the adverse
    effects this may have on medical education and
    patient care.
  • Miriam Komaromy, Andrew B. Bindman, Richard J.
    Haber, and Merle A. Sande   NEJM 1993328322-326

Behavior Often Associated with Sexual Harassment
Komaromy M et al. N Engl J Med 1993328322-326
Reports of Sexual Harassment Made in a Survey of
Medical Residents
Komaromy M et al. N Engl J Med 1993328322-326
Characteristics of Those Engaging in Sexual
Harassment, as Reported by Those Who Completed
the Survey
Komaromy M et al. N Engl J Med 1993328322-326
Behavior Associated with Sexual Harassment, as
Reported by the Study Respondents
Komaromy M et al. N Engl J Med 1993328322-326
  • Sexual harassment may be defined as sexual
    advances, requests for sexual favors, and other
    verbal or physical conduct of a sexual nature
  • submission to such conduct is made either
    explicitly or implicitly a term or condition of
    an individual's employment or academic success,
  • submission to or rejection of such conduct by an
    individual is used as a basis for employment or
    academic decisions affecting such an individual,
  • such conduct has the purpose or effect of
    unreasonably interfering with an individual's
    work or academic performance or creating an
    intimidating, hostile, or offensive work or
    academic environment.

Sexual harassment and exploitation
  • Abuse the rights and the trust of those who are
    subjected to such conduct
  • May influence the academic and professional
    advancement of medical trainees in a manner that
    is unrelated to their scholastic or clinical
  • May harm professional, working relationships
  • Likely to jeopardize patient care.

Consensual sexual relationship
  • Consensual sexual relationships between a medical
    trainee and a supervisor, when the supervisor has
    professional responsibility for the trainee, are
    objectionable because of the potential for
    exploitation and the potential impact on patient
  • Consensual sexual relationships between a medical
    trainee and a supervisor when no professional
    relationship exists may also be a cause for
  • CEJA Report B A-89 Sexual Harassment and
    Exploitation Between Medical Supervisors and

NJ on sexual harassment
  • The New Jersey Supreme Court held in 2002 that
    absent managerial and supervisory training on
    harassment, there were questions of fact as to
    whether the policy was effective and whether the
    policy could shield the organization from
    vicarious liability for supervisor misconduct.
  • See Gaines v. Bellino, 801 A.2d 322 (N.J. 2002).
    In its decision the court also noted the
    importance of making such training available to
    all employees.
  • This ruling in essence made supervisory and
    managerial training mandatory for employers
    covered by the New Jersey Law Against
    Discrimination. It also made all-employee
    training essential.

NJ laws on gender discrimiation
  • Categories Protected by state FEP Statutes
  • Training Education Requirement New Jersey Race,
    creed, color, national origin, nationality,
    ancestry, age (18-70), sex (including pregnancy,
    childbirth, and related medical conditions),
    civil union status, marital status, domestic
    partnership status, affection or sexual
    orientation, gender identity or expression,
    atypical hereditary, cellular or blood trait,
    genetic information or the refusal to submit to a
    genetic test or make available the genetic test
    of an employer, liability for service in the
    Armed Forces of the United States, mental and
    physical disability or handicap (including AIDS
    and HIV-related illnesses)
  • N.J. Stat. 105-1 et seq., 346B-1, et seq.

  • Verbal conduct such as epithets, derogatory
    comments, slurs, or unwanted sexual advances,
    invitations, or comments.
  • Visual conduct such as derogatory posters,
    photography, cartoons, drawings, or gestures.
  • Physical conduct such as unwanted touching,
    blocking normal movement, or interfering with
    work directed at you because of your sex or any
    other protected basis.
  • Threats and demands to submit to sexual requests
    in order to keep your job or avoid some other
    loss, and offers of job benefits in return for
    sexual favors.
  • Retaliation for opposing, reporting or
    threatening to report harassment, or for
    participating in an investigation, proceeding or
    hearing conducted by an investigating agency.
  • http//

David Stern 2005
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