Abuse and Sexual Harassment in Plastic Surgery Residency Training in the United States

Background: The quality of education and training that residents receive is influenced by their interactions with attendings, peers and other health care providers. These individuals can be a source of intellectual growth; however, they may also be the source of abuse and harassment. Published international studies have addressed this issue and found that harassment within residencies is a widespread phenomenon. There has not been a recent project looking at this issue in the US. The authors sought to explore the prevalence and sources of verbal, physical and sexual harassment among Plastic Surgery residents currently enrolled in integrated and independent programs across the US and delineate the frequency along gender lines.

 

Methods: After IRB approved exemption was obtained, an anonymous Internet-based survey was distributed via email to all Plastic and Reconstructive Surgery program coordinators in the US. Each coordinator was asked to distribute the survey among their residents. The survey was comprised of 23 questions focusing on personal experience or knowledge of other colleagues who had encountered abuse and/or sexual harassment during their training. There are approximately 1,064 active plastic and reconstructive surgery residents in the US. Responses were collected during a 60-day period. A total of 173 surveys were completed for a response rate of 16%. A statistical analysis of the data was performed.

 

Results: One hundred and seventy-three individuals completed the survey. There were 104 male participants (60.12%) and 69 female (39.88%). The majority of individuals were enrolled in an integrated Plastic Surgery program (70.93%), while 27% were enrolled in an independent Plastic Surgery programs and 1.74% were in other advanced fellowship (1.74%). Thirty-nine percent reported verbal abuse in the form of cursing and being called inappropriate names. Six respondents (3.64%) reported being pushed, shoved or hit with instruments in the operating room. Over nineteen percent responders admitted to having been sexually harassed at some point during their training. Female residents were victims to all types of abuse with a greater frequency than males. Thirty-six percent of the female participants experienced sexual harassment vs. nine percent of males. In most of the cases (64.52%), the instigator was a supervising physician. Most individuals who had experienced some type of harassment did not feel comfortable reporting the abuse (80.65%).

 

Conclusion: Abuse and sexual harassment among active Plastic and Reconstructive Surgery residents in the US has a high prevalence, with about 40% of respondents experiencing verbal abuse and 20% experiencing sexual harassment. Although the survey response rate was not optimal, the results are profound. The findings of this study should bring attention to this important issue. It is especially concerning that the majority of those who experienced abuse did not feel comfortable reporting the incident at their institution. Further studies should be conducted in other specialty fields in order to assess the extent of abuse and harassment experienced by residents in the US. This would ultimately raise awareness of this issue and lead to implementation of programs that provide accountability, improved support and counseling strategies, and foster appropriate professional development.