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No place for bullies, harassers in medicine: AMA

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Workplace bullies and perpetrators of sexual harassment should be hit with sanctions and penalties as part of efforts to clampdown on harassment and other unacceptable behaviour, according to the AMA.

Responding to evidence of widespread bullying and sexual harassment within medicine, the AMA has called for a cultural change in the medical workplace, led by the profession and underpinned by concrete actions by employers, educators, colleges, professional associations and unions, to encourage victims to make complaints and ensure there are repercussions for perpetrators.

The issue drew national attention after senior vascular surgeon Dr Gabrielle McMullin highlighted the problem by saying trainees who complained about sexual harassment risked ruining their career.

A subsequent report by the Royal Australasian College of Surgeons found almost 40 per cent of surgical fellows, trainees and international medical graduates said they were bullied at work, while almost one in five experienced harassment and 7 per cent reported being sexually harassed.

Among the incidents recounted in the report, one trainee said she was expected to provide sexual favours in return for being tutored by a senior colleague, while another was told she would only be considered for a job if she had her “tubes tied”.

AMA President Professor Brian Owler said the profession had been “deeply shocked and challenged” by the seriousness and breadth of the problem.

Professor Owler said such behaviour could have both immediate and lifelong effects on individuals.

“The impact of sexual harassment is profound,” he said. “It affects physical and mental health,…undermines performance and professionalism in the workplace [and] can influence career choice and career progression.

The AMA has released two Position Statements – one on sexual harassment, the other on workplace bullying and harassment – in which it declares there must be a “zero tolerance” approach to such behaviour.

But stamping it out is likely to be a long and difficult task.

In its Position Statement on Workplace bullying and harassment, the AMA warned that the hierarchical nature of medicine, the power imbalance inherent in medical training, gender and cultural stereotypes and the competitive nature of practice and training, “has engendered a culture of bullying and harassment that has, over time, become pervasive and institutionalised in some areas of medicine”.

While sexual harassment occurred in many occupations, the AMA said characteristics of the medical workforce increased the risk of it occurring, particularly the male-dominated nature of some specialities.

“Gender inequity has a proven causal relationship with the incidence [of] sexual harassment of female employees,” the AMA’s Sexual harassment in the medical workplace Position Statement said. “This is particularly relevant for medicine, where significant gender imbalances emerge in the majority of specialties.”

Professor Owler said the medical profession – including colleges and professional bodies – needed to take the lead.

But he said it could not just be left up to the profession, and there had to be collaboration with employers and educators to promote respectful and safe working and training environments.

“Tackling the problem of bullying and harassment requires changing the culture within organisations,” the AMA Position Statement said, warning that hospitals and professional associations may inadvertently foster a culture of bullying and harassment by failing to discourage it.

“Bullying and harassment thrives in a workplace culture where it progresses unchallenged and is ignored,” it said, and emphasised the need for clear and robust complaints processes.

“Incidences of bullying and harassment are often not reported because of fear or reprisal, lack of confidence in the reporting process, fear of impact on career, and [a culture of minimising the problem].”

The AMA has detailed a set of “practical and positive” measures to tackle the problem. These include:

  • making it clear there is a zero tolerance approach to bullying and harassment;
  • providing flexible work arrangements and training opportunities to ensure all are able to fully participate in the workforce;
  • educating staff and students about bullying and harassment;
  • providing robust complaints processes, including assurances that people can make complaints free of shame, stigma or repercussions;
  • encouraging and supporting bystanders to speak up and act on instances of bullying and harassment;
  • apply appropriate sanctions, consistently applied, on those who bully or harass; and
  • penalise workplaces that do not have policies in place, and which fail to properly investigate and address complaints.

The AMA Position Statement on Sexual Harassment in the Medical Workplace is available at position-statement/sexual-harassment-medical-workplace

The updated AMA Position Statement on Workplace Bullying and Harassment is at position-statement/workplace-bullying-and-harassment

Adrian Rollins