Sexual harassment rates remain high among women in medicine interns
Key takeaways:
- Researchers observed an overall decrease in sexual harassment incidence.
- Results showed an increase in sexual coercion incidence among women and nonsurgical interns.
The prevalence of training physicians’ experience of sexual harassment decreased, though the prevalence of sexual coercion doubled, with three in four female interns experiencing sexual harassment in 2023, according to study results.
The findings, published in a research letter in JAMA Health Forum, indicate that awareness of harassment has improved within medicine but much work is still needed, researchers concluded.
‘Unique stressors’
“#MeToo went viral in the fall of 2017, and we saw a renewed call to action within many fields, including medicine with #MedToo, but there really hadn’t been a lot of methodologically rigorous research on sexual harassment amongst young physicians and trainees,” Elena Frank, PhD, director of the Intern Health Study at Michigan Neuroscience Institute at University of Michigan, told Healio.
“We collected this data as a part of the broader Intern Health Study, which is a longitudinal study of mental health among first-year medical residents,” she continued. “The study started in 2007 and over the years as we’ve collected this data, we’ve became more aware that there may be unique stressors that women experience over the course of training that can have serious consequences for their well-being and careers during training and down the road. We were interested in investigating some of those factors.”
The cohort study included data from 4,178 medical interns (median age, 27 years; 51.7% women) enrolled in the longitudinal Intern Health Study in 2016, 2017 and 2022 who completed sexual harassment questions.
Participants provided electronic informed consent, received compensation of $25 to $130, and completed a follow-up survey during the last month of internship in 2017, 2018 or 2023.
The survey assessed sexual harassment using a single-item self-report question as well as the 19-item Sexual Experiences Questionnaire-Shortened (SEQ-S) — a validated, behavior-based instrument that assesses three types of sexual harassment: gender harassment, unwanted sexual attention and sexual coercion.
Researchers considered participants who endorsed at least one item of the SEQ-S to have experienced sexual harassment. They then performed logistic regression models to assess changes over time in sexual harassment prevalence and recognition, controlling for age, sex, race and ethnicity, and specialty.
‘Disturbing’ results
Researchers observed a decrease in sexual harassment incidence from 62.8% in 2017 to 54.6% in 2023 (OR = 0.92; 95% CI, 0.9-0.94), and a decrease in gender harassment incidence from 61% to 51.7% (OR = 0.91; 95% CI, 0.89-0.93).
However, they observed an increase in sexual coercion incidence among women from 2.3% to 5.5% (OR = 1.17; 95% CI, 1.08-1.28) and nonsurgical interns from 1.6% to 4% (OR = 1.18; 95% CI, 1.09-1.27).
Results additionally indicated an increase in recognition of sexual harassment from 8.6% to 18.4% (OR = 1.12; 95% CI, 1.07-1.17) that appeared greater among women vs. men and among surgical vs. nonsurgical interns.
Moreover, researchers observed an increase in gender harassment recognition overall from 8.9% to 18.9% (OR = 1.12; 95% CI, 1.07-1.17), and an increase in recognition of unwanted sexual attention among women from 29.7% to 41.8% (OR, 1.09; 95% CI, 1.03-1.16) and surgical interns from 18.8% to 52.5% (OR, 1.27; 95% CI, 1.12-1.44).
“There is an assumption that sexual harassment in medicine should gradually be getting better over time, but it is quite disturbing to see how high these rates still are just in our 1-year study period,” Frank said. “The majority of women and men in medicine continue to experience some form of harassment and that tells us that this is a highly pervasive problem that needs to be addressed and taken very seriously.”
Researchers noted limitations of the study, including the underreporting and potentially influential events beyond #MeToo during the study period.
Next steps
“The field of medicine was originally designed around men and how their lives were structured, which included having a partner at home to take care of everything for them,” Frank told Healio. “Now that women are a huge part of the field, and the majority of the incoming field, it’s important to attend to these ongoing issues.”
Next steps for Frank and colleagues include working to identify some program level or specialty level factors that might contribute to differences in various fields and to look more closely at the sources of harassment.
“Preliminary qualitative data from our study and recent work from others tell us that this harassment is not just coming from attending physicians, it could be coming from patients and their families, and from fellow trainees as well,” Frank said. “We will be taking a closer look at the sources of harassment, which will be an important part of helping to diagnose the problem and identifying potential solutions. We are making progress in medicine when it comes to gender equity, but we still have a long way to go and a lot of work to do.”
For more information:
Elena Frank, PhD, can be reached at emfrank@med.umich.edu.
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