Sexual misconduct in medicine must end

A survey of 2458 doctors in a report on sexism in medicine for the British Medical Association (a UK based trade union for doctors) found that 91% of women doctors had experienced sexism at work, 42% of whom felt they could not report it to their organisation or training programmes.7 Such high levels of sexism accord with multiple reports about wider discrimination in the surgical profession and the degree to which sexism, racism, and homophobia are embedded in the discipline.5,8 High profile sexual misconduct cases in surgery have occurred in many countries.9–11 But the same cycle of inaction recurs: feigned shock, condemnation, and promises to act on recommendations that never get delivered. A US study of 125 faculty (97·6% male) in academic medicine who had been accused of sexual misconduct (affecting at least 1668 individuals) between 1982 and 2019 showed that as many as 50 remained in academia, of whom 40% held positions at a different institution.12 Similarly, a UK analysis of 275 fitness to practise cases involving sexual misconduct within patient and colleague relationships, found doctors (in this cohort all male) were more likely to receive a suspension compared with nurses, who were more likely to be removed from the professional register.13 Weak governance, an underappreciation of the impact sexual misconduct can have on patient outcomes, and misogyny all contribute to a failure in accountability and the impunity male perpetrators enjoy. There is good evidence, across multiple studies in varied countries and settings, that there is a positive association between a psychologically safe work environment and patient outcomes.18,19 Sexual misconduct impacts the workplace culture and a woman surgeon's feeling of psychological safety and wellbeing.