PC1026: Sexual Harassment: A Survey on Prevalence and Frequency Amongst Pediatric Emergency Medicine Fellowship Trainees

Background: Up to 91% of medical trainees experience at least one form of harassment or discrimination during their training. Abuse during medical training has been shown to correlate with an increase in the frequency of depression and suicide attempts, particularly for female physicians. Despite prior research efforts to bring attention to this issue, a decline in the high prevalence of harassment and discrimination among medical trainees has not been observed. While sexual harassment has been described in relation to medical students and residents, the prevalence and frequency of sexual harassment has not been studied at the fellowship level.

Methods:

Objective:
Primary outcome is to identify the prevalence and frequency of sexual harassment. Secondary outcomes include: 1. identifying possible correlations between a trainees’ gender or fellowship location and the incidence of sexual harassment; and 2. quantifying the fellowship programs’ intolerance of harassment, resources available to trainees, and the long-term effects of sexual harassment.

Methods:
A retrospective cross-sectional survey was distributed to pediatric emergency medicine (PEM) fellows through the American Academy of Pediatrics (AAP) PEM Fellowship Program Director Survey Committee in June 2021. Demographic information was collected. Fellows were asked to quantify their experience of sexual harassment utilizing a Likert scale, and who perpetrated these acts. Sexual harassment was further delineated as sexual impropriety (gestures and expressions) and transgression (inappropriate touching).

The Psychological Climate for Sexual Harassment (PCSH) Questionnaire was included. The questionnaire was used to provide an impression of the perceived organizational climate in supporting and fighting harassment when reporting incidents.

Results: 140 (26%) of 546 fellows identified in the NRMP Specialty Match Results from 2019 – 2021 participated in the survey. Surveys that were partially completed were included. Sexual transgression and impropriety were experienced by 9% of total respondents and was most prevalent among cis females (17% ). Perpetrators of sexual transgression and impropriety were mostly men (93% of all reported events). While the majority of respondents report access to resources for recognizing (84%) and reporting (86%) sexual harassment, most incidents of sexual harassment are not reported (13%).

Conclusion: This pilot study suggests that sexual harassment is still prevalent at a fellowship level. Limitations include the distribution of the survey and response rate which affected the power of the study. Further studies will need to be done with the goal of creating meaningful and sustainable interventions aimed at addressing this pervasive issue in order to protect future generations of doctors.