Dr. Reshma Jagsi has her finger on the pulse of the medical field — she’s an associate professor and deputy chair of radiation oncology at the University of Michigan Medical School. She also received her education at a time when 47 percent of medical school students are women, according to the Association of American Medical Colleges. So it came as a shock to learn about the pervasiveness of sexual harassment among physicians.

“I don’t want to sound naive, but I have to say that I did not expect that three out of 10 women would report harassment in their career compared to 4 percent of men,” she told Medical Daily about her new JAMA study. “You think, ‘Hey, the world has changed; we’ve taken strides to make to achieve gender equity.’ It’s a sobering statistic.”

The study was part of a larger one aiming to understand why, despite the high number of women in medical schools, few graduate to leadership roles and become deans, department chairs, or college professors. Some have argued that the pipeline to these positions just moves slowly. But Jagsi has done research in this area before, and she suspected women might be facing unique challenges and barriers. She was also inspired by results of a 1995 survey that found 52 percent of American women in academic faculty roles were sexually harassed compared to just 5 percent of men. Now that more women interested in medicine find themselves in fairly gender-balanced classes, Jagi thought it would be a good time to replicate the survey with a contemporary cohort.

She and her colleagues surveyed samples of men and women who had received K08 and K23 career development awards from the National Institutes of Health from 2006 to 2009. These awards are given to physician-scientists who have finished clinical training and show a commitment to pursuing clinical research. The questionnaire evaluated career and personal experiences, and included questions about gender bias, advantage, and varied levels of sexual harassment, from generalized sexist remarks to subtle bribery to engage in sexual behavior and coercive advances.

Seventy-seven percent of women perceived more sexual harassment than men, in addition to reporting more personal experiences of harassment. Among those women, 40 percent described more severe forms of discrimination and believed it had a negative effect on their professional self-confidence, and some thought it also affected their career advancement.

One of the study’s limitations, though the authors tried to take steps to avoid this, was the potential for a nonresponse bias. Those with no personal experience of harassment may have been less likely to respond than those with a personal story to share, making it seem more prevalent than it actually is. Participants in the survey answered questions about the broader topics of mentorship and negotiations before they got to questions on gender-specific harassment, said Jagsi, “so we don’t think the sample was selected in a way that might have been biased.”

It didn’t make it into the study, at least not in a meaningful way, but Jagsi also looked at racial disparity. With participants self-reporting race — non-Hispanic white versus other — she could see a few minorities in faculty roles; however, the number was too small to bear any statistical power and reveal any true differences.

Diversity is important for all three of the missions in academic medicine: research, education, and patient care, Jagsi said. A component of that care should also be mindful of values, beliefs, and traditions of different cultural groups.

She continued: “It provides role models, and research shows that diversity actually improves the discourse, makes people ask better questions and come to more creative solutions. You arrive at more innovative answers when you bring together a bunch of people with different backgrounds and life experiences.”

That’s why Jagsi’s committed to understanding the gender gap, ultimately hoping the results of her continued investigation help reshape academic medicine. With such highly promising men and women, we need to understand the root causes of equity at the most senior levels, she said. Sexual harassment and discrimination has lessened over the years, but it’s hardly isolated. And that’s true outside of medical school, too, she added. Her results are a reminder that we still have a long way to go before achieving gender equity in our society.

“Sometimes I get pushback as to why this matters, but I think it’s important to document experiences to show that they’re not rare,” Jagsi said. “People out there, myself included, don’t realize how common these experiences still are today; they aren’t aberrational now that we’re [actively working to] promote equity. If we think this is solved, we may miss an opportunity for cultural transformation.”

Source: Jagsi R, et al. Sexual Harassment and Discrimination Experiences of Academic Medical Faculty. JAMA. 2016.