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Sexual harassment common in surgical training programs

(Reuters Health) – About seven in 10 young female surgeons say they have experienced at least one form of sexual harassment during their training, according to a new survey.

That was true for nearly half of surgery trainees of both genders, researchers found.

Many never reported it because they thought reporting it would be a waste of time, or because they feared repercussions, the study authors wrote in Annals of Surgery.

“As in any other workplace, hospital workers suffer from failures of professionalism and other outwardly unacceptable behaviors,” said senior author Dr. Peter Yoo, who is the program director of the surgical residency at the Yale School of Medicine in New Haven, Connecticut.

“I see this as an obstacle to creating the circumstances where young surgeons can perform at their peak,” he told Reuters Health by email.

Yoo and colleagues surveyed 270 male and female residents in 16 general surgery training programs across the country. The survey asked about residents’ experiences with behaviors considered to be sexual harassment by the U.S. Department of Labor and the Association of Women Surgeons, including subtle messaging through words or actions, explicit sexual advances and uninvited physical contact. The survey also asked whether residents had reported the behaviors and how they did it, as well as potential barriers to reporting harassment.

They found that 70 percent of women and 49 percent of all residents experienced at least one form of sexual harassment during their training. Among the half who didn’t personally experience harassment, about 33 percent said they witnessed or heard about an incident of sexual harassment among their peers.

The most common types of harassment were sexist remarks, sexually explicit comments or jokes, and discussion of the resident’s body in an inappropriate manner. Nearly 60 incidents involved physical touch, unwanted nudity, or being propositioned or followed.

Women most commonly experienced sexist remarks, and men most commonly experienced sexually explicit comments or jokes. About 87 percent of residents, both male and female, reported being personally harassed by a male. At the same time, the harasser was typically of the opposite sex.

Among all hospital staff, nurses were the most common perpetrators of harassment, followed by attending physicians and senior residents. Female residents were most commonly harassed by attending physicians, and male residents were most commonly harassed by nurses.

“Observations like this one challenge traditional thinking about gender and professional roles that still linger in our daily biases,” Yoo said. “Our research uncovered that understanding the landscape of harassment and other sexual dynamics in the workplace is far more complicated than we thought.”

Among the 130 residents who experienced harassment, only 10 reported it. Among those who didn’t report it, 62 percent thought the action was harmless, 48 percent thought reporting it would be a waste of time, 38 percent said they were too busy, and 32 percent weren’t sure if the behavior qualified as sexual harassment. In terms of barriers, 37 percent feared retaliation or other repercussions from reporting.

“Surgical training brings small teams together in close physical proximity over long hours in ways that can blur boundaries,” said Dr. Reshma Jagsi of the University of Michigan in Ann Arbor. Jagsi, who wasn’t involved with this study, has researched workplace sexual harassment in medicine.

Creating public reports about the range of complaints filed, as well as the investigations conducted and sanctions issued, could create a zero-tolerance workplace, Jagsi added.

“Sexual harassment in settings like surgery is a very real problem that can have direct impact on the quality of care patients receive,” she told Reuters Health by email. “Patients need to be able to count on having access to health care environments that are safe, equitable and dignified.”

SOURCE: Annals of Surgery, online April 2, 2019.

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