Back to Front PageVOLUME 6, NUMBER 4

Leadership Q & A

'No One Is Immune': Study Author Discusses Gender Discrimination In Medical Schools

Phyllis Carr, M.D., is the primary author of "Faculty Perceptions of Gener Discrimination and Sexual Harassment in Academic Medicine."

If you ask a female medical school faculty member, gender-based discrimination is endemic. If you ask a male member, it's virtually non-existent.

At least that's the finding of a new study conducted by Massachusetts General Hospital and the Boston University School of Medicine-the broadest yet to assess sexual harassment and gender-based discrimination among medical school faculty.

The study, published in the June 6 Annals of Internal Medicine and funded in part by the Robert Wood Johnson Foundation, reports that female faculty members are more than 2.5 times as likely as their male counterparts to perceive gender-based discrimination in the academic environment.

In addition, more than half of female medical school faculty believe that gender bias has hampered their professional development, while about 30 percent of female faculty report serious forms of sexual harassment, including unwanted sexual advances, bribery, or threats. And more than 50 percent say they have been sexually harassed by a superior or colleague, compared with 5 percent of men.

Titled "Faculty Perceptions of Gender Discrimination and Sexual Harassment in Academic Medicine," the study tallies responses from 1,979 randomly selected faculty members at 24 medical schools in the contiguous U.S.

The AAMC Reporter asked primary author Phyllis Carr, M.D., about the study and its implications for academic medical centers.

Q. When compared with other studies, this analysis indicates that gender-based discrimination and sexual harassment against women physicians are more commonplace in teaching hospitals than they are in other settings. Are there aspects of academic medical centers' structure and culture that contribute to this?

A. I think there are several aspects of academic medical life that contribute to these problems. First, the hierarchical structure of most medical schools tends to put women at a disadvantage. Women typically are not high in the power structure and thus have little input into the way schools are run and little ability to change things. Secondly, women remain a minority of faculty, although a steadily increasing one. Lastly, networking has always been important in academic medicine. Women tend to be in less powerful networks and excluded from key ones.

Q. Not only is the widespread perception by women that they are victims ofgender-based discrimination and sexual harassment disconcerting, but so is the large discrepancy between men's and women's perceptions of the existence of such discrimination in the workplace. Why such a "gender disconnect"?

A. The gender disconnect is a puzzle. Since existing research shows that relationships appear to be more central in women's lives, these issues may have greater importance in the workplace for women than they do for men. Also, since men don't seem to feel harassed or discriminated against to any significant extent, they are in general less aware of gender issues for women.

Q. What prompted you to undertake this study? Do the results dovetail with your experiences as a woman in medicine?

A. This paper was part of a larger project funded by the Robert Wood Johnson Foundation that explores many aspects of academic life for women, minorities, and generalists in medicine. We wished to understand barriers to advancement and academic productivity for these groups, including the effects of gender discrimination and sexual harassment. While I have seen these problems during my years in academic medicine, their prevalence as indicated in the study is higher than I would have surmised from my experience.

Q. What actions should academic medical centers take in response to this study?

A. I think academic medical centers need to look closely at their institutions and individually evaluate themselves to determine what they need to do to put their house in order. From our study, these problems are similarly prevalent in all areas of the country and in public and private institutions, so no one is immune.

Q. Is there something that can be done in the first years of medical school that will decrease the frequency of sexual harassment later on?

A. I think that the approach needs to be more systematic; it must cover all areas in medical schools and emanate from the top. Spot solutions in certain sectors will not be effective.

Q. Is it right to assume that the prevalence of sexual harassment will decrease as the number of women entering medicine continues to increase?

A. The data on specialty give some credence to this hypothesis, however, I don't think the data overall support this. (Women in primary care reported less harassment than those in surgical specialties in the study.) Even in primary care specialties, in which there are greater numbers of women, both gender discrimination and sexual harassment occur at disturbingly high rates. We can't rely on the increasing number of women to solve these problems.

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Phyllis Carr, M.D., primary author of "Faculty Perceptions of Gender Discrimination and Sexual Harassment in Academic Medicine," is the director of the Women's Health Elective at Massachusetts General Hospital and the Harvard Medical School. She also is an assistant professor at the Harvard Medical School and co-chair of the education committee for the Center for Excellence in Women's Health at the school.

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