A former medical director of the United Nations has called on Australia’s regulator of health professionals to specifically ask about sexual harassment in its regular survey of trainee doctors, saying it is “inexplicable” that this data is not collected.
The Medical Board of Australia (MBA) sponsors the medical training survey, a longitudinal survey that tracks the quality of medical training and questions respondents on workplace culture, including experiences of harassment, racism, discrimination and bullying.
The survey does not explicitly ask about sexual harassment, leaving those who have experienced it to instead respond “yes” to the general question on harassment.
The chief executive of the “A Better Culture” of medicine project, Dr Jillann Farmer, said she had raised her concerns with the MBA to no avail.
“I have consulted with a number of workplace experts and I have not found a single person who agrees that it is appropriate to bundle harassment and sexual harassment in together,” said Farmer, who previously oversaw the health and safety of all UN personnel.
“Although the word harassment appears in both, the dynamics and impacts – and in fact, the criminality in some cases – are completely different. I raised this concern with MBA staff well before the design of the current release but again they have chosen not to include it.
“The net impact of continuing to bundle them together is to silence the people who experience this – who are predominantly, but not exclusively, women.”
It comes after reporting by Guardian Australia of sexual harassment in medicine by doctors against other – often junior – medical staff, prompting calls for an independent body to handle complaints.
Researchers and doctors who have experienced sexual harassment say workplaces are ill-equipped to handle complaints because hospitals benefit from the high-profile work of doctors accused of harm and cannot investigate in an unbiased way, while junior doctors are fearful of career implications from complaining internally.
A spokesperson for the MBA said when sexual harassment happens at work, “existing employer complaints resolution processes are the best first step”.
The spokesperson confirmed specific types of harassment are not collected in the trainee doctors survey. “The board reviews questions every year and will consider whether more granular data – splitting out sexual harassment from harassment more widely – will help drive positive change and build a culture of respect in medicine,” she said.
“A Better Culture”, led by Farmer, has been tasked by the federal health department to find solutions to change behaviours and culture.
“It is inexplicable to me that the board would not embrace the need to ask the question, not least because there is also the issue of potential patient safety,” Farmer said.
“The discourse in the UK recently has surfaced the probability that doctors who transgress sexual boundaries with their female colleagues may be more likely to do so with vulnerable female patients.”
A survey of National Health Service staff in the UK, reported by the BBC in September, found nearly two-thirds of female surgeons said they had been the target of sexual harassment and a third had been sexually assaulted by colleagues in the past five years.
Female doctors were also more likely than male doctors to die by suicide, Farmer said, often thought to be driven by dual demands, societal expectations, role conflict and gender bias.
“We have never had a conversation about the link between sexual harassment and suicide – it’s a great taboo– but the stories we do hear are those of the survivors – the ones who are still alive to tell, and they all describe the terrible impact on their mental health that sexual harassment has had,” Farmer said.
Dr Nada Hamad, an associate professor, transplant haematologist and deputy co-chair of the equity, diversity and inclusion in medicine committee at UNSW, said for the MBA to run a questionnaire that does not specifically include sexual harassment is “disingenuous”.
“It’s extraordinarily damaging to human beings to be assaulted in this way,” Hamad said.
“On top of this, people do not believe women. Or they will respond to an assault by saying it wasn’t ‘that severe,’ or that the perpetrator is ‘a good man of good character’.
“While it is frustrating that we need more evidence, when there’s enough evidence to support that women are being harmed within the medical profession, to not ask a question about sexual harassment in a survey like this is just turning a blind eye.”
Do you know more? Email melissa.davey@theguardian.com
Information and support for anyone affected by rape or sexual abuse issues is available in Australia at 1800Respect (1800 737 732). In the UK, Rape Crisis offers support on 0808 500 2222. In the US, Rainn offers support on 800-656-4673. Other international helplines can be found at ibiblio.org/rcip/internl.html
