Tara Lauriat, PhD
Program Director for Academic Affairs
Harvard Medical School
Faculty members are expected to demonstrate professionalism in their interactions with colleagues, trainees, staff, and patients to maintain an environment that is welcoming and respectful to everyone. Most faculty do this routinely, but as with any group of people, some individuals do not meet this standard. Troubling behaviors may include bullying and subtler microaggressions. Faculty affairs offices need to work with other administrative leaders at their institutions to develop policies that define standards of professional behavior for faculty members and procedures to follow when someone fails to comply with the code of conduct.
The World Medical Association defined workplace bullying to include intimidating, offensive, threatening, insulting, or humiliating behavior that is recurring.1 Legal protection against harassment only applies when a victim is targeted based on being a member of a protected class, and institutions may not have formal policies to support those not protected by the law.
Clinical faculty members who mistreat or humiliate subordinates, including trainees and nurses, create an environment of intimidation that can lead to depression and burnout among health care professionals and put patients at risk.1 When such behavior is not addressed, it sends a message to trainees and others that the negative behavior is acceptable and normal. In the research setting, aggressive senior investigators may place unrealistic expectations on members of the lab and create an environment where competition replaces collaboration. Although anyone can be a target, international trainees and junior faculty members are particularly vulnerable. If they lose their position or resign, they may lose their visa status and need to leave the country.
Microaggressions are a special category of troubling behaviors because they are often unintentional. Chester Pierce, MD, introduced the term in the 1970s, but Derald Wing Sue, PhD, popularized it in a 2007 publication on racial microaggressions.2 Microaggressions are slights, insults, and actions that marginalized groups experience in their daily interactions with others. An example is complimenting an Asian American student on her perfect English, implying that she is not American. Although microaggressions are often subtle, the cumulative psychological effects on faculty members or trainees who experience them can be substantial. Introducing this topic into unconscious bias training may be beneficial, as people are often unaware that their comments or actions may be distressing to colleagues.
Dealing With Inappropriate Faculty Behavior
One way a faculty affairs office might discourage unprofessional behavior is by coordinating with its general counsel’s office to draft language requiring an attestation of professionalism in hiring, promotion, tenure, reappointment, and other relevant processes. This may prompt department heads who are aware of troubling behavior to work with faculty members to try to improve their behavior before they are evaluated for promotion, for example, by recommending coaching. Professionalism is a core competency for residents; faculty members should be expected to demonstrate mastery of the same competencies throughout their careers. When a faculty affairs colleague and I reviewed letter solicitation templates from several medical schools, we found that relatively few institutions explicitly ask letter writers to comment on candidates’ integrity and professionalism during promotion and tenure reviews.
Another opportunity to address professionalism is during the faculty recruitment process. Competency-based and behavioral interviewing approaches can identify candidates who have impressive academic credentials but lack the emotional intelligence and interpersonal skills needed to serve effectively in leadership roles.
Faculty members and trainees need to feel there is a safe environment for raising concerns. However, this is often challenging due to the hierarchical nature of academic medicine and the resulting power differentials between senior faculty members and junior colleagues. In addition, maintaining anonymity is not always possible, leading to fear of retribution. Usually only a few trainees are in any given lab, fellowship, or rotation at any one time, making it difficult to protect the identity of a whistleblower.
Dealing with troubling behavior requires skills in which some faculty affairs deans may lack training. Whenever possible, deans should do this work in concert with expert colleagues and may need to consult with human resources professionals, the general counsel’s office, psychologists, social workers, organizational development professionals, and others, as every organization has its own set of idiosyncrasies and nuances. Deans may have access to different resources, such as an employee assistance program (EAP) or an ombudsperson who may offer coaching to leaders preparing for difficult conversations. Troubled faculty members may be encouraged to use these resources as well. An EAP or an ombudsperson may also offer bystander training so other team members have the proper tools to speak up when they witness unacceptable behavior.
A final note relates to safety. Although incidents involving disgruntled faculty members are rare, there have been cases where deans and others have been physically harmed following a negative tenure decision or termination for cause. It is best to have challenging conversations when others are present and have an emergency plan in place.
- World Medical Association. WMA statement on bullying and harassment within the profession. wma.net/policies-post/wma-statement-on-bullying-and-harassment-within-the-profession. Accessed Sept. 17, 2020.
- Sue DW, Capodilupo CM, Torino GC, et al. Racial microaggressions in everyday life: implications for clinical practice. American Psychologist. 2007;62(4):271-286. doi:10.1037/0003-066X.62.4.271.