These academic healthcare institutions were not built to report on inequity, harassment and people in power, said Dr. Dara Kass, a founding member of Time's Up Project Japan and an assistant professor of emergency medicine at Columbia University and CEO of FeminEM, an organization for women in emergency medicine.
"The culture of academics is the fertile soil and harassment grows from there," she said.
A 2018 Association of American Medical Colleges of 16,223 U.S. medical school graduates revealed that 42.1% reported personally experiencing sexist, racist, or other offensive comments or humiliation; lower grades; or denial of training or awards based on gender identity, sexual orientation, race, or ethnicity. That was up from 39.3% in 2017.
More specifically, 16.5% reported being subjected to sexist names during medical school, 6.9% said they had been denied training opportunities or rewards based on gender, 6.4% believed they had received lower grades solely based on gender, 4.9% received unwanted sexual advances, and 0.2% had been asked to exchange sexual favors for better grades or rewards.
Nearly 9% reported that the were subjected to ethnically offensive names, 3.3% reported being denied training or rewards based on race, 3% said they received lower grades based solely on race, 2.3% had been subjected to offensive names related to their sexual orientation, and 0.6% said they had received lower grades or had been denied opportunities because of their sexual orientation.
Several healthcare providers have joined the effort as signatories—Warren Alpert Medical School of Brown University, Drexel University College of Medicine, Mayo Clinic, University of Wisconsin-Madison Health, the School of Medicine and Public Health at the University of Wisconsin-Madison and the Yale School of Medicine.
It's a long game, Kass said. Ideally, women in healthcare are empowered by a broad connection with their peers, she said. Then, they can increase awareness and education on the ground level at their respective organizations and boost access to the defense fund, Kass said.
"If we facilitate empowering women who have been silent, I expect us to see an uptick in claims," she said. "Hopefully we can bring them out of the shadows and let them know 'Your voice matters.'"
Boston University School of Medicine's Dr. Karen Antman wrote in a 2018 JAMA that there have been some promising changes in the healthcare industry following the #MeToo movement.
The National Science Foundation announced new reporting requirements for scientists on NSF grants found guilty of sexual harassment, and the National Academies of Sciences, Engineering and Medicine sponsored a study of sexual harassment in academia and its effects on women's career advancement, she wrote.
Medical school bylaws and human resources teams have established and developed educational programs to identify sexual misconduct and outline reporting standards.
Institutions are also completing sexual harassment investigations rather than ending them when an accused faculty member resigns. They are also reconsidering confidentiality agreements for accused faculty in return for their departure, Antman wrote.
But there is much more progress to be made, she said.
Medicine is at a tipping point as more women and young people enter the workforce, two Wake Forest Baptist Medical Center employees, Dr. Julie Freischlag and Paula Faria, wrote in a 2018 JAMA .
"For the young people of this generation, as well as people of the generations that preceded them and who work in academic medical centers, healthcare institutions and other settings, now is the time for mutual respect, for utmost civility, and for women (and men) to be brave in putting an end to sexual harassment and abuse," they wrote.