Gender discrimination and sexual harassment in medical education: perspectives gained by a 14-school study.

PURPOSE: The authors attempted to determine male and female medical students' exposures to and perceptions of gender discrimination and sexual harassment (GD/SH) in selected academic and nonacademic contexts.

METHOD: An anonymous, self-report questionnaire was administered in the spring of 1997 to senior medical students at 14 U.S. medical schools. Data were collected about students' exposures to GD/SH during undergraduate medical education and outside the medical training environment. Students' perceptions of GD/SH in various medical specialties and practice settings were also measured.

RESULTS: Of the 1,911 questionnaires administered, 1,314 were completed (response rate, 69%). Both men and women reported exposures to GD/SH. More women than men reported all types of exposures to GD/SH across all academic and nonacademic contexts. Differences between men and women in the frequencies of exposures were greatest outside the medical training environment (t = 15.67, df = 1171, p <or=.001). Within academic medical training contexts, the differences by sex were most evident in core clerkships (t = 11.17, df = 1176, p <or=.001). Women students perceived the prevalence of GD/SH to be significantly (p <or=.001) higher in a number of medical specialties than did men. However, both groups believed these behaviors to be most common in general surgery and obstetrics-gynecology. Women perceived significantly more GD/SH in academic medical centers and community hospitals. Both groups perceived these behaviors to be significantly more prevalent in academic medical centers than in community hospitals, and more prevalent in community hospitals than in outpatient office settings.

CONCLUSIONS: This study suggests that mistreatment in the form of GD/SH is prevalent in undergraduate medical education, particularly within core clerkships. Interventions focused on particular specialties and training periods may be helpful.