Recupero Patricia Ryan, Heru Alison M, Price Marilyn, Alves Jody
Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906.
Acad Med. 2004 Sep;79(9):817-24. doi: 10.1097/00001888-200409000-00002.
The prevalence and frequency of sexual harassment in medical education is well documented. On the graduation questionnaire administered by the Association of American Medical Colleges in 2003, 15% of medical students reported experiences of mistreatment during medical school. On items that specifically address sexual mistreatment, over 2% of students reported experiencing gender-based exclusion from training opportunities, and unwanted sexual advances and offensive sexist comments from school personnel. Sexual harassment of medical trainees by faculty supervisors is obviously unethical and may also be illegal under education discrimination laws. In two cases in 1998 and 1999, the U.S. Supreme Court clarified that schools may be held liable under Title IX of the Education Amendments of 1972 for the sexual harassment of their students. In 2001, the Office of Civil Rights of the Department of Education released revised policy guidelines on sexual harassment that reflect the Supreme Court rulings. Medical school administrators should undertake formal assessments of the educational environment in their training programs as a first step toward addressing the problem of sexual harassment. The authors recommend that medical schools implement measures to both prevent and remedy sexual harassment in their training programs. These constructive approaches include applying faculty and student education, establishing a system for notification and response, and creating an institutional structure to provide continuous evaluation of the educational environment.
医学教育中性骚扰的发生率和频率已有充分记录。在美国医学院协会2003年进行的毕业问卷调查中,15%的医学生报告在医学院期间有过受虐待的经历。在专门针对性虐待的问题上,超过2%的学生报告曾遭遇基于性别的培训机会排斥,以及学校工作人员不必要的性侵犯和冒犯性的性别歧视言论。教师督导员对医学实习生的性骚扰显然是不道德的,根据教育歧视法也可能是非法的。在1998年和1999年的两起案件中,美国最高法院阐明,学校可能会因违反1972年《教育修正案》第九条而对其学生遭受的性骚扰承担责任。2001年,教育部民权办公室发布了关于性骚扰的修订政策指南,这些指南反映了最高法院的裁决。医学院管理人员应首先对其培训项目中的教育环境进行正式评估,以此作为解决性骚扰问题的第一步。作者建议医学院在其培训项目中采取措施预防和纠正性骚扰。这些建设性方法包括开展教师和学生教育、建立举报和回应系统,以及创建一个对教育环境进行持续评估的制度架构。