Highlights
- •Patient-derived GBD is experienced by the majority of resident physicians.
- •Women physicians are ubiquitously affected by patient-derived GBD.
- •Women are more likely to experience personal and professional consequences of patient-derived GBD.
- •Current reporting mechanisms do not adequately capture or address patient-derived GBD.
Abstract
Background
This study characterizes prevalence, frequency, and forms of patient-derived gender-based
discrimination (GBD) experienced by resident physicians, as well as their experiences
witnessing and reporting patient-derived GBD.
Methods
A web-based survey was sent to residents from 12 programs at three academic institutions.
Results
Response rate was 47.9% (309/645) with 55.0% of respondents identifying as women.
Women were more likely than men to experience patient-derived GBD during residency
(100% vs 68.8%, p < 0.001), including inappropriate physical contact, receiving less
trust from patients, and being mistaken for a nurse (p < 0.001). While 85.9% of residents
personally experienced and 95.0% of residents witnessed patient-derived GBD, only
3.4% of residents formally reported patient-derived GBD. Women were more likely to
report negative personal and professional consequences of patient-derived GBD.
Conclusions
Patient-derived GBD is pervasive and disproportionately affects women residents. Current
reporting mechanisms are not adequately capturing nor addressing patient-derived GBD.
Keywords
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References
- How to Define and Address Gender Discrimination and Sexual Harassment in Surgical Training.American College of Surgeons Resources in Surgical Education, 2019 (Available:)
- Resident experience of abuse and harassment in emergency medicine: ten years later.J Emerg Med. 2010; 38: 248-252
- The prevalence of medical student mistreatment and its association with burnout.Acad Med. 2014; 89: 749-754
- Student perceptions of mistreatment and harassment during medical school. A survey of ten United States schools.West J Med. 1991; 155: 140-145
- Gender discrimination and sexual harassment in medical education: perspectives gained by a 14-school study.Acad Med. 2002; 77: 1226-1234
- Does students’ exposure to gender discrimination and sexual harassment in medical school affect specialty choice and residency program selection?.Acad Med. 2005; 80: 400-408
- Medical students’ experiences with sexual discrimination and perceptions of equal opportunity: a pilot study in Germany.BMC Med Educ. 2020; 20: 56
- Assessing medical students’ perceptions of mistreatment in their second and third years.Acad Med. 1997; 72: 728-730
- “Yes, I’m the doctor”: one department’s approach to assessing and addressing gender-based discrimination in the modern medical training era.Acad Med. 2019; https://doi.org/10.1097/ACM.0000000000002845
- Discrimination, abuse, harassment, and burnout in surgical residency training.N Engl J Med. 2019; 381: 1741-1752
- Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex.Arch Surg. 2011; 146: 211-217
- Sexual harassment and discrimination experiences of academic medical faculty.J Am Med Assoc. 2016; 315: 2120-2121
- Perceptions of gender-based discrimination during surgical training and practice.Med Educ Online. 2015; 20: 25923
- The relationship between perceived gender judgment and well-being among surgical residents.Am J Surg. 2018; 215: 233-237
- Experiencing the culture of academic medicine: gender matters, a national study.J Gen Intern Med. 2013; 28: 201-207
- Barriers to advancement in academic surgery: views of senior residents and early career faculty.Am J Surg. 2013; 206: 661-666
- Sex differences in physician salary in US public medical schools.JAMA Intern Med. 2016; 176: 1294-1304
- “I’m too used to it”: a longitudinal qualitative study of third year female medical students’ experiences of gendered encounters in medical education.Soc Sci Med. 2012; 74: 1013-1020
- Sexual harassment of female doctors by patients.N Engl J Med. 1993; 329: 1936-1939
- A qualitative study of sexual harassment of female doctors by patients.Soc Sci Med. 1997; 45: 669-676
- Burnout and self-reported patient care in an internal medicine residency program.Ann Intern Med. 2002; 136: 358-367
- Special report: suicidal ideation among American surgeons.Arch Surg. 2011; 146: 54-62
- Integration of gender-transformative interventions into health professional education reform for the 21st century: implications of an expert review.Hum Resour Health. 2016; 14: 14
- Engineering, and medicine, policy and global affairs, committee on women in science, engineering, and medicine, committee on.The Impacts of Sexual Harassment in Academia. Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine. National Academies Press, 2018
- The value of mentorship in orthopaedic surgery resident education: the residents’ perspective.J Bone Joint Surg Am. 2009; 91: 1017-1022
- Mentoring programs for physicians in academic medicine: a systematic review.Acad Med. 2013; 88: 1029-1037
- Promoting success: a professional development coaching program for interns in medicine.J Grad Med Educ. 2015; 7: 630-637
- Sexual harassment and abuse: when the patient is the perpetrator.Lancet. 2018; 392: 368-370
- Racism as experienced by physicians of color in the health care setting.Fam Med. 2020; 52: 282-287
- Race as a predictor of job satisfaction and turnover in US nurses.J Nurs Manag. 2017; 25: 207-214
- Common Ground Healthcare. Know-The-Line Campaign.Massachusetts General Hospital, Boston2019 (Aug 9)
Article info
Publication history
Published online: October 14, 2020
Accepted:
October 11,
2020
Received in revised form:
September 16,
2020
Received:
June 11,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
