Prevalence of gender-based and sexual harassment within orthopedic surgery in Canada

Giglio, Victoria; Schneider, Patricia; Bond, Zoe; Madden, Kim; McKay, Paula; Bozzo, Anthony; Bhandari, Mohit; Ghert, Michelle

doi:10.1503/cjs.013120

Cited by 12 publications

(11 citation statements)

References 14 publications

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“…Other studies have explored the presence and effects of microaggressions, male culture, and misidentification and highlighted the lack of mentoring and harassment faced by female and URiM orthopaedic surgeons [17][18][19][20][21][22][23] . In a study by Brooks et al, 89% of surveyed Black orthopaedic surgeons experienced some form of racial microaggression in the workplace, with higher rates reported by Black female surgeons 24 .…”

Section: Discussionmentioning

confidence: 99%

Racial and Sex Disparities in Resident Attrition in Orthopaedic Surgery

et al. 2023

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Background: Studies have suggested that female individuals and individuals from backgrounds under-represented in medicine (URiM) are at increased risk of attrition during residency. This likely exacerbates the lack of diversity in our field. The aims of this study were to (1) characterize demographic composition in orthopaedic residency from 2001 to 2018 and (2) determine the race/ethnicity and identify any disparities. Methods: Demographic and attrition data from 2001 to 2018 were obtained from the Association of American Medical Colleges. Attrition data comprised the following categories: withdrawals, dismissals, and transfers to another specialty. Analysis compared demographic composition and determined attrition rates with subgroup analysis by race/ethnicity and sex. Results: From 2001 to 2018, female orthopaedic residents increased from 8.77% to 15.54% and URiM residents from 9.49% to 11.32%. The overall and unintended attrition rates in orthopaedic surgery were 3.20% and 1.15%, respectively. Among female residents, the overall and unintended attrition rates were 5.96% and 2.09% compared with 2.79% and 1.01%, respectively, in male residents. URiM residents had overall and unintended attrition rates of 6.16% and 3.11% compared with 2.71% and 0.83%, respectively, for their White counterparts. Black/African American residents had an attrition rate of nearly 10%. Female residents averaged 12.9% of all residents but 24% of those leaving orthopaedics. URiM residents were 10.14% of all residents but 19.51% of those experiencing attrition. In logistic regression models, female residents had a relative risk (RR) of 2.20 (p < 0.001) for experiencing all-cause attrition and 2.09 (p < 0.001) for unintended attrition compared with male residents. Compared with their White male counterparts, URiM residents had a RR for overall and unintended attrition of 2.36 and 3.84 (p < 0.001), respectively; Black/African American residents had a RR for the same of 3.80 and 7.20 (p < 0.001), respectively. Conclusion: Although female resident percentage has increased, orthopaedics continues to train fewer female surgeons than all other fields. Female and URiM residents in orthopaedic surgery are disproportionately affected by attrition. While recruitment has been the primary focus of diversity, equity, and inclusion efforts, this study suggests that resident retention through appropriately supporting residents during training is equally critical.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A524).

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Section: Discussionmentioning

confidence: 99%

Racial and Sex Disparities in Resident Attrition in Orthopaedic Surgery

et al. 2023

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“…The protocol for this study was previously published as a preprint (https://osf.io/e5c6n/). The definitions of gender-based and sexual harassment used throughout the survey and the primary outcome of this survey quantifying the prevalence of gender-based and sexual harassment were previously published 1 . This study was approved by the Hamilton Integrated Research Ethics Board (Project #4848).…”

Section: Methodsmentioning

confidence: 99%

“…Survey development has been previously published in detail 1 . Briefly, we developed a unique 116-item cross-sectional survey to assess the prevalence of gender-based and sexual harassment within orthopaedic surgery and investigate details on these harassment behaviors, including who the perpetrator(s) was/were and when the behavior(s) occurred (Appendix).…”

Section: Methodsmentioning

confidence: 99%

“…Sexual harassment is bullying or coercion of a sexual nature or the unwelcome or inappropriate promise of rewards in exchange for sexual favors. A survey distributed to members of the Canadian Orthopaedic Association (COA) revealed that 76% of the respondents reported at least 1 occurrence of gender-based harassment and 74% of the respondents reported at least 1 occurrence of sexual harassment 1 . Similarly, a recent survey distributed to women and underrepresented minority members of the American Academy of Orthopaedic Surgeons (AAOS) reported that 79% of the members had been exposed to discrimination, 55% had been exposed to bullying, 47% had been exposed to sexual harassment, and 40% had been exposed to harassment 2 .…”

Section: Introductionmentioning

confidence: 99%

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Perpetrators of Gender-Based and Sexual Harassment in the Field of Orthopaedic Surgery

et al. 2022

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Background: The prevalence of gender-based and sexual harassment in the field of orthopaedic surgery in Canada is high. Previous research in other jurisdictions has identified the most common perpetrators of harassment to be senior surgeons or directors. We aimed to identify the most frequent perpetrators of gender-based and sexual harassment in orthopaedic surgery in Canada. Methods: We conducted a Canada-wide survey of all orthopaedic surgeons registered with the Canadian Orthopaedic Association and the Canadian Orthopaedic Residents’ Association. The development of our 116-item questionnaire was informed by a review of the literature and other published gender-based and sexual harassment surveys. Descriptive analyses, including frequency counts with associated 95% confidence intervals (CIs), are reported for all data. Results: Of the 465 survey respondents, the median age was 43 years (interquartile range, 35 to 59) and respondents were most commonly male (72%), White (81%), married (77%), and staff orthopaedic surgeons (68%). Peers were identified as the most common perpetrators of gender-based harassment (55%, 95% CI, 50 to 59), and patients were identified as the most common perpetrators of sexual harassment (48%, 95% CI, 43 to 52). Women were more likely to report direct supervisors or patients as the perpetrators of gender-based and sexual harassment, and men reported peers as the most common perpetrators. Conclusion: Orthopaedic surgery peers and patients are the most commonly reported perpetrators of gender-based and sexual harassment in Canada. The results of this study may be helpful to institutions in designing and focusing educational programs and/or policies and procedures to help reduce harassment incidents in the training and work environment.

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“…Sexual harassment is common in medicine ( 1 ) and oncology ( 3 ) yet rarely reported to persons in authority ( 8 ). A recent multispecialty study from an academic medical institution suggested that the reporting rate was only 11% in that setting ( 7 ), and the Canadian Orthopaedic Association discovered a reporting rate of only 17.5% among orthopedic surgeons ( 9 ). This study confirms that low rates of reporting also occur in oncology and suggests reliance on reporting systems alone is unlikely to suffice; preventive initiatives are essential.…”

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confidence: 99%

Frequency, barriers, outcomes, and consequences of reporting sexual harassment in clinical oncology

Graff

Subbiah

Markham

et al. 2022

JNCI Cancer Spectrum

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Sexual harassment is increasingly recognized as widely prevalent in medicine. Broad efforts at the organizational and society level are working to address this inequity, but many of these efforts rely on reporting to eradicate problematic behaviors and shift culture. We examined, among oncologists experiencing sexual harassment, the frequency of reporting, as well as barriers, outcomes, and consequences of reporting. Among 271 survey respondents, 217 reported sexual harassment from either peers/superiors or patients/families. Most harassed oncologists (n = 148, 68%) did not report the event to authority due to concerns about future negative consequences for themselves. Among the minority who reported harassment (n = 31, 14%), 52% felt their concerns were not taken seriously and 55% report no action was taken as a result of their report. Furthermore, 52% experienced retaliatory behavior. Addressing these findings may help to inform the change necessary to create an antiharassment culture in oncology.

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Prevalence of gender-based and sexual harassment within orthopedic surgery in Canada

Cited by 12 publications

References 14 publications

Racial and Sex Disparities in Resident Attrition in Orthopaedic Surgery

Racial and Sex Disparities in Resident Attrition in Orthopaedic Surgery

Perpetrators of Gender-Based and Sexual Harassment in the Field of Orthopaedic Surgery

Frequency, barriers, outcomes, and consequences of reporting sexual harassment in clinical oncology

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