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Breaking the cycle: Academic medical centers need to build cultures that stop sexual harassment

 

The list of documented sexual harassment cases in research settings keeps growing: 

In 2015, the University of Washington banned a renowned Ebola scientist from his own lab after confirming employee complaints.  

The same year, a University of California, Berkeley investigation found one of the university’s astronomers had harassed multiple students over a decade. He ultimately resigned.  

Last January, Caltech suspended an astrophysics professor for a year after determining he sexually harassed two of his graduate students.  

A month later, a University of Chicago molecular biologist resigned amid reports of sexual harassment at his previous job.  

And academic medical centers are not immune to the phenomenon, panelists told a group of deans, faculty members and students gathered at the annual Association of American Medical Colleges’ 2016 conference Sunday. “Sexual harassment is not yet a problem of the past,” said Reshma Jagsi, M.D., University of Michigan Health System professor and deputy chair in the Department of Radiation Oncology. 

A landmark 1995 survey of medical school faculty found what some thought was reason for optimism—lower rates of reported sexual harassment among younger faculty members. While more than two-thirds of the older faculty members surveyed 20 years ago reported sexual harassment over the course of their careers, that rate dropped to 47 percent among younger faculty members. 

Over time, researchers figured, sexual harassment rates would continue dropping significantly among medical school faculty. But when researchers revisited the survey’s topic and methodology in a report published in JAMA last May, they found that 30 percent of female medical school faculty still reported some incidence of sexual harassment over the course of their careers. Four percent of male medical school faculty reported being harassed or bullied. The harassment included sexist remarks, unwanted advances and subtle bribery or threats to engage in sexual behavior. Nearly half of those faculty members—47 percent— reported the harassment had a significant impact on their career advancement.

Some of the problem can be blamed on historic imbalances between men and women in medical school faculty. For generations, medicine has been a field dominated by men. That is changing, but slowly. Women make up just over half of medical school applicants and 53 percent of biomedical sciences Ph.D.s, but they represent just 16 percent of medical school deans. 

In a flash, smartphone poll of audience members Sunday, just under two-thirds reported experiencing some sort of sexual harassment. The panel discussion was the first of its kind at an AAMC conference, organizers said. 

“Academic medicine has a huge hierarchy,” said Yale Medical School Dean Robert Alpern, “and it leaves our members vulnerable and unable to respond to this kind of behavior. We have a list at Yale—“Six Ways to Respond [to Sexual Harassment].’ People said, ‘Instead of telling us how to respond, why don’t you tell your faculty how to behave?’” The AAMC crowd erupted in spontaneous applause. 

Government research funders also are limited in what they can do to stop harassers from moving up, unaffected by their behavior, said Michael Lauer, M.D., deputy director for extramural research at the National Institutes of Health. 

“We don’t want [sexual harassers] applying for grants. We don’t want them getting grants. We don’t want them sitting on our peer-review panels,” Lauer said. “We’re having a hard enough time giving out grants to deserving scientists as it is. There really can be very little tolerance here.” 

The AAMC panelists agreed some sexual harassment policy steps are more window-dressing than effective. Repetitive training sessions, for example, or regular town hall meetings may make administrators feel better but accomplish little to change toxic behavior. What does seem to work, they said, are smaller group sessions or appointing senior professors and administrators who can serve as confidants for students or junior faculty who need to report an incident. 

In the end, truly tamping down sexual harassment in the sometimes hyper-masculine environs of research laboratories and operating rooms will require a change in culture, panelists said. Students, understandably, are afraid of endangering their careers by filing a complaint, Alpern said. And the offending faculty members may be unaware of the impact of their actions or willfully defiant. Combatting that mindset will require changing entire institutions through strong leadership and vigilance. 

“We have to fix it ourselves. And the key is culture change,” Yale’s dean added. “It has to be aspirational. People don’t change the way they behave out of fear. They change the way they behave because they aspire to be better. We have to get this into the conversation so that everyone realizes this is something they want to be better at.” 

By: Rebecca Walsh

Rebecca Walsh is a Senior Writer for University of Utah Health Sciences.