Physician Health

How accreditors can help stop harassment of doctors in training

Timothy M. Smith , Contributing News Writer

Trainees sometimes face sexual harassment during medical school and residency, but recent data show the scale of the problem demands renewed attention from accreditation authorities.

Nearly half of female students in medical school or in graduate school for a health care field report having experienced sexual harassment during their training, according to a 2018 National Academies of Sciences, Engineering and Medicine report.

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In addition, female medical students are 220% more likely to experience unwanted crude behavior from faculty or staff compared with female students in nonscientific fields.

These statistics, along with others highlighting the magnitude of the problem, were included in an AMA Medical Student Section resolution urging sexual harassment accreditation standards for medical training programs that was adopted by the AMA House of Delegates.

“In the absence of an institutional culture that promotes sexual harassment training at all levels and the importance of incident reporting as part of the solution to mitigate sexual harassment, sexual harassment training and reporting methods are not effective at reducing sexual harassment of medical trainees,” the resolution noted.

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The Liaison Committee on Medical Education (LCME)—the accreditation authority for U.S. allopathic medical schools—already has some relevant standards in place.

Standard 3.6, “Student Mistreatment,” states: “A medical school develops effective written policies that define mistreatment, has effective mechanisms in place for a prompt response to any complaints, and supports educational activities aimed at preventing mistreatment. Mechanisms for reporting mistreatment are understood by medical students, including visiting medical students, and ensure that any violations can be registered and investigated without fear of retaliation.”

Meanwhile, Standard 3.4, “Anti-Discrimination Policy,” states: “A medical school has a policy in place to ensure that it does not discriminate on the basis of age, disability, gender identity, national origin, race, religion, sex, sexual orientation or any basis protected by federal law.”

When reviewing schools for accreditation, the LCME collects data related to both standards, including whether students perceive being subjected to sexual harassment. The LCME also asks what medical schools have done to prevent all types of student mistreatment and to act on reports from students that they were subject to mistreatment.

Similarly, the Accreditation Council for Graduation Medical Education (ACGME) “requires residency and fellowship programs to maintain a professional environment free from sexual harassment, but does not explicitly state how that standard is evaluated,” the resolution noted.

In addition, The Joint Commission requires education for all staff about workplace violence, which includes sexual harassment.

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To improve sexual harassment accreditation standards for medical training programs, the AMA is encouraging stakeholders to create a standard for accreditation that includes sexual harassment training, policies and repercussions for sexual harassment in undergraduate and graduate medical education programs.

The AMA also is encouraging key stakeholders to assess:

  • Medical trainees’ perception of institutional culture regarding sexual harassment and preventive trainings.
  • Sexual harassment prevalence, reporting, investigation of allegations and Title IX resource utilization in order to recommend best practices.

The AMA has sent letters to the ACGME, the Commission on Osteopathic College Accreditation and the LCME requesting their assistance in addressing the issue.