Shattering the silence of sexual harassment

It is one of the most insidious practices in our society and no area of life or profession is immune, including the medical profession.

Sexual harassment in society has been with us for thousands of years. But the battle to end this demonstration of power must be a concerted campaign by all of us.

Most countries now have legislation making sexual harassment a crime – but still it goes on.

It goes on because we as a society basically are too self-programmed to not see it, tolerate it or completely ignore it.

There are many males out there who are disgusted by it, and yet have tolerated it – even joked about it in order to handle it. But there are many of us who would have seen people destroyed by it, leaving their jobs or their education.

Most of the time, perpetrators are believed first, with complainants forced to resign to make life easier for a company.

There is no area of society – no matter what we tell ourselves – that can claim “it doesn’t happen here”.

If anyone is not already aware of the pervasiveness of sexual harassment within the medical profession, then the AMA (WA) Survey will, unfortunately, clearly show that it is a serious and even an endemic problem.

The AMA (WA) and the Department of Health believes there is no place in the medical profession for sexual harassment. We are committed to a zero tolerance policy towards sexual harassment and will continue to play a role in tackling this issue.

We are also fully committed to supporting the cultural and attitudinal changes that need to occur in the medical profession. We know that the will and determination to improve the profession exists.

In light of the heightened awareness and recognition of the damage caused by sexual harassment, the AMA (WA) determined it was incumbent upon us to ensure the issue is addressed. Ignorance and misunderstanding serve only to perpetuate inaction. We therefore made a decision to survey all medical practitioners and medical students in the State in order to establish the extent to which sexual harassment affects the profession in Western Australia.

When we sent out the AMA (WA) Survey on Sexual Harassment in the Workplace (the Survey) in 2015, we were aware that such an emotive issue would be likely to provoke a strong response. We were not prepared, however, for what was the largest response to an Association survey conducted to date – more than 950 medical practitioners and medical students responded in just three days.

If the response was remarkable, the results generated from the survey were staggering. They highlighted the plight of generations of medical students and doctors in training (DiTs), compounded by a systemic failure of responsible organisations to tackle the issues at hand.

All survey respondents were invited to complete the survey anonymously and the AMA (WA) was clear that it would not prosecute or take further, any individual accusations that were made or implied.

We asked the respondents a number of key questions in order to gauge the extent to which sexual harassment impacts on the profession, what action their employers have taken to create a workplace environment free from, and how effective current processes employed are in dealing with, incidents of sexual harassment.

Recognising that people have different opinions of what constitutes sexual harassment, we provided a definition, based on federal and state legislation. Further, we specified that all responses should relate to experiences between colleagues from the medical profession.

In March 2015, Dr Gabrielle McMullin, a Sydney vascular surgeon, made comments regarding the extent of sexism amongst surgeons, stating that from a professional perspective, the safest thing a trainee could do when approached for sex is to comply; the worst thing they could do is to complain.

Dr McMullin’s comments, linking the successful professional progression of medical trainees to unwavering obedience and stoicism, even in the face of unwelcome sexual advances, sparked a national conversation about sexual harassment, bullying and discrimination in the medical profession.

These sentiments ignited an introspective examination of the experience of current medical trainees, and those of their predecessors and successors. Media coverage has focused particularly on the Royal Australasian College of Surgeons.

The case of the Victorian surgical trainee Dr Caroline Tan was held up by some, as a prime example of how inherent components of the medical profession and its institutions, such as ab initio recruitment and its competitive, hierarchical training structure, have created an environment where inappropriate behaviour has been tolerated.

Moreover, ‘speaking up’, even if the law and morality are on your side, can severely limit your career and the professional opportunities open to you. However, it is naïve for anyone in the medical profession to think that these issues only exist in certain specialties or occur at specific locations. Many might not know of any incidents of sexual harassment or they may be blind to the spectrum of action or inaction that amounts to sexual harassment.

Whatever the personal experiences of the practitioners, the profession has a responsibility to recognise that sexual harassment is a systemic issue that pervades the medical profession.

On a professional level, sexual harassment impacts the professional and personal relationships that exist between doctors; the high esteem in which the community holds the profession; and most importantly, the impact on the profession’s ability to provide best care for patients.

For a victim of sexual harassment, the impact can devastate their professional and personal life, and have a detrimental impact on their physical, emotional and mental wellbeing. There should be no understating the gravity of the problems the medical profession faces, or the level of resolve that will be needed to combat what has so far failed to have been tackled.

Following the four-month period where the AMA (WA) Survey on Sexual Harassment in the Workplace was open for respondents to complete, we have been compiling the data provided, reviewing independent testimonies left in the survey and engaging with our members and employers in relation to the survey results.

An action panel comprising of the then AMA (WA) President Dr Michael Gannon, both AMA (WA) Vice Presidents and a number of male and female members from a range of specialties and positions, was formed in order to review the results to date and formulate a course of action that the AMA (WA) would take in relation to the issue of sexual harassment.

Since the meeting of this group, the Association (WA) has written to the Director General of the Department of Health (WA); the chief executive officers of both St John of God Health Care and Ramsay Health Care; and the respective Deans’ of the University of Western Australia and the University of Notre Dame. Their responses can be viewed here

The AMA has shared its concern, in addition to the survey data, with these organisations in order to collaborate with them to encourage positive change in workplace and training environments. It is incumbent on all employers to ensure that they provide a workplace environment free from discrimination and to enable reporting procedures for those who encounter sexual harassment.

Our educational institutions owe a duty of care to their students, to ensure they remain supported and able to learn in an environment free from sexual harassment.

The AMA is dedicated to advocating on behalf of our members to ensure that their workplace or educational institution remains safe, productive and supportive.

As an initial step towards positive change and a zero tolerance approach towards sexual harassment, both the AMA (WA) and the Department of Health (WA) have committed to work together to tackle this.

The Taskforce Against Sexual Harassment (TASH) will investigate this complex issue and propose a framework to act on and hopefully, substantially reduce incidences of sexual harassment in WA Health.

The AMA looks forward to engaging with all employers and educational institutions that wish to take similar action. We will also continue to engage with the medical profession in order to assess the rate at which positive change is occurring and to highlight deficiencies in the medical profession’s approach towards inequality, discrimination and sexual harassment.

In the meantime, the AMA remains available to anyone who wishes to discuss any of the issues raised by the survey

We cannot change this practice overnight, or single handedly. But we must start.