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“Yes, I’m the Doctor”: One Department’s Approach to Assessing and Addressing Gender-Based Discrimination in the Modern Medical Training Era

McKinley, Sophia K. MD, EdM; Wang, Linda J. MD, MBA; Gartland, Rajshri M. MD, MPH; Westfal, Maggie L. MD, MPH; Costantino, Christina L. MD; Schwartz, Dana MD; Merrill, Andrea L. MD; Petrusa, Emil PhD; Lillemoe, Keith MD; Phitayakorn, Roy MD, MHPE; for the Massachusetts General Hospital Gender Equity Task Force

doi: 10.1097/ACM.0000000000002845
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While gender-based bias and discrimination (GBD) is known to exist in medical training, there is limited guidance for training programs on how to understand and combat this issue locally. The Massachusetts General Hospital Department of Surgery established the Gender Equity Task Force (GETF) to address GBD in the local training environment. In 2017, members of the GETF surveyed residents in surgery, anesthesia, and internal medicine at 2 academic hospitals to better understand perceived sources, frequency, forms, and effects of GBD. Overall, 371 residents completed the survey (60% response rate, 197 women). Women trainees were more likely to endorse personal experience of GBD and sexual harassment than men (P < .0001), with no effect of specialty on rates of GBD or sexual harassment. Patients and nursing staff were the most frequently identified groups as sources of GBD. While an overwhelming majority of both men (86%) and women (96%) respondents either experienced or observed GBD in the training environment, less than 5% of respondents formally reported such experiences, most frequently citing a belief that nothing would happen. Survey results served as the basis for a variety of interventions addressing nursing staff and patients as sources of GBD, low confidence in formal reporting mechanisms, and the pervasiveness of GBD, including sexual harassment, across specialties. These results reproduce other studies’ findings that GBD and sexual harassment disproportionately affect women trainees while demonstrating how individual training programs can incorporate local GBD data when planning interventions to address GBD.

S.K. McKinley is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

L.J. Wang is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

R.M. Gartland is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

M.L. Westfal is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

C.L. Costantino is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

D. Schwartz is resident physician, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

A.L. Merrill is a fellow, Department of Surgery, Ohio State University, Columbus, Ohio.

E. Petrusa is associate professor, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

K. Lillemoe is professor and chair, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

R. Phitayakorn is associate professor, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A703.

Funding/Support: Funding for participant incentives was provided by the Partners Center of Expertise in Medical Education and the Massachusetts General Hospital Department of Surgery.

Other disclosures: None reported.

Ethical approval: The survey protocol was approved by the Institutional Review Board of Partners HealthCare (protocol number 2017P001789).

Previous presentations: Portions of these data were presented at the annual meeting of the Massachusetts Chapter of the American College of Surgeons, Boston, December 1, 2018 (local meeting).

Correspondence should be addressed to Sophia K. McKinley, Massachusetts General Hospital, 55 Fruit St., GRB 425, Boston, MA 02114; telephone: (617) 832-5899; email: skmckinley@partners.org.

Copyright © 2019 by the Association of American Medical Colleges