Women in Medicine: Are We "There" Yet?

Jessica Freedman, MD

Disclosures

November 16, 2010

In This Article

Gender Bias, Sexual Harassment Common in Medical Training

When it comes to gender issues, however, the news for women physicians is not as promising. Any discussion of "gender issues" in medicine must include the subject of sexual harassment -- which unfortunately appears to be alive and well. A 1993 survey of internal medicine residents, for example, found that 73% of the women reported having been sexually harassed at least once during their training, compared with 22% of the men. Only 2 of the women reported their experiences to an authority, saying they were not confident that they would receive any help with the situation.[2]

But this article was published in 1993. Maybe sexual harassment has decreased since then? Apparently not. According to a 2000 survey of more than 3000 full-time faculty members at 24 randomly selected US medical schools, about half of the female faculty experienced some form of sexual harassment.[3] Further, the report found that 48% of female academic physicians experienced sexist comments or behavior (compared with 1% of male colleagues), and 30% of female academic physicians experienced severe harassment, including sexual solicitation, threats, or coercive sexual advances (compared with 3% of male colleagues).[3]

A 2009 study examined the effect of gender on clinical clerkship experiences of female medical students and revealed other insights on this issue. Although some of the 12 third-year medical students who were interviewed mentioned instances of sexual harassment, these incidents were not pervasive. However, they cited other gender-related experiences that were more formative in shaping their clerkship rotations and ideas about women in medicine.[4] During the first month of clinical rotations, for example, most female medical students found themselves behaving in stereotypical "feminine" ways, such as offering assistance to nursing or support staff, nurturing patients, or being apologetic for any errors. While the female students thought such behavior was "helpful" in their interactions with support staff and patients, they believed it had a negative effect on their interactions with residents and attendings. The female students said they apologized for mistakes for which they were not wholly responsible or acted insecure about their skills. The students also noted that while they formed relationships with the predominantly female nursing and support staff, the male students were forming relationships with their generally male attendings. Some respondents thought that attendings had lower expectations of women residents than their male counterparts. In addition, while female medical students felt able to negotiate uncomfortable situations with patients (such as being called "nurse"), they were unable to do so in similar situations with supervisors and attendings.

This study also revealed that female medical students had several contradictory perspectives. Although they reported that uncomfortable situations typically arose with male clinical supervisors, they still thought male physicians were better teachers than their female peers. Similarly, although the students expressed a desire to work more with female supervisors, virtually all of them reported that their experiences with female attendings and residents were disappointing, which suggests that the students themselves had internalized sexist attitudes.

The study's authors noted that their findings indicate the need to expand the framework of what is considered gender discrimination beyond sexual harassment to include subtle forms of gender stereotyping that are experienced during early medical training.

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