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. 1996 Jun 1;154(11):1657–1665.

Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

D J Cook 1, J F Liutkus 1, C L Risdon 1, L E Griffith 1, G H Guyatt 1, S D Walter 1
PMCID: PMC1487906  PMID: 8646653

Abstract

OBJECTIVE: To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. DESIGN: Self-administered questionnaire. SETTING: McMaster University, Hamilton, Ont. PARTICIPANTS: Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. OUTCOME MEASURES: Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. RESULTS: Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p < 0.01). Ten respondents, all female, reported having experienced discrimination on the basis of their sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p < 0.01), reported experiencing offensive body language and receiving sexist teaching material and unwanted compliments on their dress. Significantly more female respondents than male respondents stated that they had reported events of sexual harassment to someone (p < 0.001). The most frequent emotional reactions to sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). CONCLUSION: Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems.

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Selected References

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  1. Baldwin D. C., Jr, Daugherty S. R., Eckenfels E. J. Student perceptions of mistreatment and harassment during medical school. A survey of ten United States schools. West J Med. 1991 Aug;155(2):140–145. [PMC free article] [PubMed] [Google Scholar]
  2. Bhugra D., King M. Controlled comparison of attitudes of psychiatrists, general practitioners, homosexual doctors and homosexual men to male homosexuality. J R Soc Med. 1989 Oct;82(10):603–605. doi: 10.1177/014107688908201013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Carr M. L., Robinson G. E., Stewart D. E., Kussin D. A survey of Canadian psychiatric residents regarding resident-educator sexual contact. Am J Psychiatry. 1991 Feb;148(2):216–220. doi: 10.1176/ajp.148.2.216. [DOI] [PubMed] [Google Scholar]
  4. Chaimowitz G. A. Homophobia among psychiatric residents, family practice residents and psychiatric faculty. Can J Psychiatry. 1991 Apr;36(3):206–209. doi: 10.1177/070674379103600309. [DOI] [PubMed] [Google Scholar]
  5. Chaimowitz G. A., Moscovitch A. Patient assaults on psychiatric residents: the Canadian experience. Can J Psychiatry. 1991 Mar;36(2):107–111. doi: 10.1177/070674379103600206. [DOI] [PubMed] [Google Scholar]
  6. Conley F. K. Toward a more perfect world--eliminating sexual discrimination in academic medicine. N Engl J Med. 1993 Feb 4;328(5):351–352. doi: 10.1056/NEJM199302043280513. [DOI] [PubMed] [Google Scholar]
  7. Cook D. J., Griffith L. E., Cohen M., Guyatt G. H., O'Brien B. Discrimination and abuse experienced by general internists in Canada. J Gen Intern Med. 1995 Oct;10(10):565–572. doi: 10.1007/BF02640367. [DOI] [PubMed] [Google Scholar]
  8. Firth-Cozens J. Source of stress in women junior house officers. BMJ. 1990 Jul 14;301(6743):89–91. doi: 10.1136/bmj.301.6743.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Friedman R. C., Downey J. I. Homosexuality. N Engl J Med. 1994 Oct 6;331(14):923–930. doi: 10.1056/NEJM199410063311407. [DOI] [PubMed] [Google Scholar]
  10. Geddes V. A. Lesbian expectations and experiences with family doctors. How much does the physician's sex matter to lesbians? Can Fam Physician. 1994 May;40:908–920. [PMC free article] [PubMed] [Google Scholar]
  11. Gillon R. Refusal to treat AIDS and HIV positive patients. Br Med J (Clin Res Ed) 1987 May 23;294(6583):1332–1333. doi: 10.1136/bmj.294.6583.1332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Grant L. The gender climate of medical school: perspectives of women and men students. J Am Med Womens Assoc. 1988 Jul-Aug;43(4):109-10, 115-9. [PubMed] [Google Scholar]
  13. Kelly C. E. Bringing homophobia out of the closet: antigay bias within the patient-physician relationship. Pharos Alpha Omega Alpha Honor Med Soc. 1992 Winter;55(1):2–8. [PubMed] [Google Scholar]
  14. Kirshner B., Guyatt G. A methodological framework for assessing health indices. J Chronic Dis. 1985;38(1):27–36. doi: 10.1016/0021-9681(85)90005-0. [DOI] [PubMed] [Google Scholar]
  15. Komaromy M., Bindman A. B., Haber R. J., Sande M. A. Sexual harassment in medical training. N Engl J Med. 1993 Feb 4;328(5):322–326. doi: 10.1056/NEJM199302043280507. [DOI] [PubMed] [Google Scholar]
  16. Mathews W. C., Booth M. W., Turner J. D., Kessler L. Physicians' attitudes toward homosexuality--survey of a California County Medical Society. West J Med. 1986 Jan;144(1):106–110. [PMC free article] [PubMed] [Google Scholar]
  17. Matthews D. A., Classen D. C., Willms J. L., Cotton J. P. A program to help interns cope with stresses in an internal medicine residency. J Med Educ. 1988 Jul;63(7):539–547. doi: 10.1097/00001888-198807000-00005. [DOI] [PubMed] [Google Scholar]
  18. Moscarello R., Margittai K. J., Rossi M. Differences in abuse reported by female and male Canadian medical students. CMAJ. 1994 Feb 1;150(3):357–363. [PMC free article] [PubMed] [Google Scholar]
  19. Phillips S. P., Schneider M. S. Sexual harassment of female doctors by patients. N Engl J Med. 1993 Dec 23;329(26):1936–1939. doi: 10.1056/NEJM199312233292607. [DOI] [PubMed] [Google Scholar]
  20. Reuben D. B., Novack D. H., Wachtel T. J., Wartman S. A. A comprehensive support system for reducing house staff distress. Psychosomatics. 1984 Nov;25(11):815–820. doi: 10.1016/S0033-3182(84)72942-2. [DOI] [PubMed] [Google Scholar]
  21. Richman J. A., Flaherty J. A., Rospenda K. M., Christensen M. L. Mental health consequences and correlates of reported medical student abuse. JAMA. 1992 Feb 5;267(5):692–694. [PubMed] [Google Scholar]
  22. Rose L. Homophobia among doctors. BMJ. 1994 Feb 26;308(6928):586–587. doi: 10.1136/bmj.308.6928.586. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Sheehan K. H., Sheehan D. V., White K., Leibowitz A., Baldwin D. C., Jr A pilot study of medical student 'abuse'. Student perceptions of mistreatment and misconduct in medical school. JAMA. 1990 Jan 26;263(4):533–537. [PubMed] [Google Scholar]
  24. Silver H. K., Glicken A. D. Medical student abuse. Incidence, severity, and significance. JAMA. 1990 Jan 26;263(4):527–532. [PubMed] [Google Scholar]
  25. Tinmouth J., Hamwi G. The experience of gay and lesbian students in medical school. JAMA. 1994 Mar 2;271(9):714–715. doi: 10.1001/jama.271.9.714. [DOI] [PubMed] [Google Scholar]
  26. Toth E. L., Collinson K., Ryder C., Goldsand G., Jewell L. D. Committee to prevent and remediate stress among house staff at the University of Alberta. CMAJ. 1994 May 15;150(10):1593–1597. [PMC free article] [PubMed] [Google Scholar]
  27. Wallick M. M., Cambre K. M., Townsend M. H. How the topic of homosexuality is taught at U.S. medical schools. Acad Med. 1992 Sep;67(9):601–603. doi: 10.1097/00001888-199209000-00013. [DOI] [PubMed] [Google Scholar]
  28. Wolf T. M., Randall H. M., von Almen K., Tynes L. L. Perceived mistreatment and attitude change by graduating medical students: a retrospective study. Med Educ. 1991 May;25(3):182–190. doi: 10.1111/j.1365-2923.1991.tb00050.x. [DOI] [PubMed] [Google Scholar]
  29. van Ineveld C. Stress in residency training: symptom management or active treatment? CMAJ. 1994 May 15;150(10):1549–1551. [PMC free article] [PubMed] [Google Scholar]

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