Differences in abuse reported by female and male Canadian medical students.

OBJECTIVE: To assess differences between male and female medical students concerning their experiences of abuse during training in a large Canadian medical school. DESIGN: Voluntary, anonymous cross-sectional survey of first- and fourth-year medical students during February 1991. SETTING: University of Toronto School of Medicine. PARTICIPANTS: Of 396 first- and fourth-year students surveyed after one of their regular classes, 347 (117 women, 230 men) completed the questionnaire. INTERVENTION: A 165-item, multiple-choice questionnaire concerning experiences of verbal or emotional abuse, sexual harassment and physical abuse, completed within 30 minutes. MAIN OUTCOME MEASURES: Differences between male and female respondents in abuse experiences before and during medical training, the relation between abuse before and during training, and the psychologic and behavioural effects of abuse during training. RESULTS: The experiences of the male and female respondents differed mainly in regard to sexual harassment: 42% (49/117) of the women and 11% (25/230) of the men reported sexual harassment before entering medical school (p < 0.0001); 46% (54/117) and 19% (43/230) respectively reported sexual harassment during medical training (p < 0.0001); and women who reported sexual harassment were the only respondents for whom a significant relation was found between abuse before and during training (p < 0.043). The women were more distressed than the men by all forms of abuse. A significant relation was shown between male students who reported experiencing abuse during medical training and mistreating patients (p < 0.0001). CONCLUSION: Female students'' experiences of sexual harassment differed from those of their male counterparts. As well, the female students'' reactions to and ways of coping with all types of abuse differed from those of the male students.     

Residents' experiences of abuse,discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

OBJECTIVE: To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. DESIGN: Self-administered questionnaire. SETTING: McMaster University, Hamilton, Ont. PARTICIPANTS: Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. OUTCOME MEASURES: Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents'' perceived frequency of sexual harassment. RESULTS: Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p < 0.01). Ten respondents, all female, reported having experienced discrimination on the basis of their sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p < 0.01), reported experiencing offensive body language and receiving sexist teaching material and unwanted compliments on their dress. Significantly more female respondents than male respondents stated that they had reported events of sexual harassment to someone (p < 0.001). The most frequent emotional reactions to sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). CONCLUSION: Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems.     

Advances in the understanding of same-sex and opposite-sex sexual harassment

Sexual harassment has traditionally been studied as men's harassment of women. This has led to a lack of knowledge about same sex harassment, and women harassing peers. This has also downplayed the inherent sexual nature of sexual harassment acts. While keeping in mind that sexual harassment is undesirable and causes distress, one needs to consider that many acts that are perceived as unwanted may not primarily be motivated by a wish to derogate but rather by an interest in soliciting short-term sex. In the current study we examined both perpetrators as well as victims of harassment, and specified both sex of perpetrator and target (a total of eight sex constellations). We reproduced the previously found association between unrestricted sociosexuality and sexual harassment in a representative sample of 1326 high school students (57% women). In all regression models sociosexuality outcompeted traditional measures such as porn exposure, rape stereotypes and hostile sexism. Based on the original work we divided the harassment acts into two groups of tactics: sexual solicitation and competitor derogation. Men were particularly subject to derogatory tactics from other men, while women were particularly subject to solicitation from opposite sex peers. Sexual harassment may be understood better from a human sexual strategies perspective, including competitor derogation and mate solicitation. As such, sociosexual orientation predicts both same sex derogation and opposite sex solicitation. The current results highlight the importance of considering the sex of both perpetrator and target. This advanced understanding of the inherently sexual nature of sexual harassment needs to inform future prevention studies. Unrestricted sociosexuality predicts sexual harassment in all constellations better than traditional social science models.     

Mistreatment Due to Weight: Prevalence and Sources of Perceived Mistreatment in Women and Men

FALKNER, NICOLE H, SIMONE A. FRENCH, ROBERT W. JEFFERY, DIANNE NEUMARK-SZTAINER, NANCY E. SHERWOOD, AND NOELLE MORTON. Mistreatment due to weight: prevalence and sources of perceived mistreatment in women and men. Obes Res. Objective: Previous research has documented prejudicial attitudes and discrimination against overweight people. Yet the extent to which overweight people themselves perceive that they have been mistreated because of their weight has not been carefully studied. The purpose of this study was to examine the prevalence of perceived mistreatment due to weight and sources of perceived mistreatment. Methods and Procedures: A non-clinical sample of healthy adults (187 men and 800 women) enrolled in a weight gain prevention program comprised the study population. A self-administered questionnaire was used to measure perceived mistreatment due to weight. Results: Overall, 22% of women and 17% of men reported weight-related mistreatment. The most commonly reported sources of mistreatment among women were strangers (12. 5%) and a spouse or loved one (11. 9%). Men were most likely to report mistreatment by a spouse or loved one (10. 2%) and friends (7. 5%). Somewhat surprisingly, sex differences in perceived weight-related mistreatment were significant only for stranger as the source. Perceived weight-related mistreatment was positively associated with body mass index (BMI) (r = 0. 39, p<0. 0001). Reported mistreatment was nearly ten times as pervalent among individuals in the highest quartile of the BMI distribution (42. 5%) than among those in the lowest BMI quartile (5. 7%), but was significantly greater than zero in all but the very lean. Discussion: Perceived mistreatment due to weight is a common experience and is not restricted to the morbidly obese. Results are discussed in light of the sociocultural value for thinness.     

The British Columbia Positive Women's Survey: a detailed profile of 110 HIV-infected women

OBJECTIVE: To describe the health, social environment, medical care received and satisfaction with medical care of HIV-infected women in British Columbia. DESIGN: Self-administered 75-item questionnaire distributed by mail or in person between March 1994 and February 1996 through community AIDS organizations and physicians'' offices. SETTING: British Columbia. PARTICIPANTS: A total of 110 HIV-positive women. OUTCOME MEASURES: Sociodemographic data, risk factors for HIV infection, details about HIV testing, health status and medical treatment, use of health care services, degree of satisfaction with medical care and psychosocial stressors. RESULTS: Most of the women surveyed were aged 25 to 39 years (70.0%), were Canadian born (76.4%) and were white (80.9%). Over one-third did not complete high school, and half had an annual household income of less than $20,000. Of the 110 women 51.8% had children, who were HIV-positive in 12.3% of cases. The most frequently reported risk factor for HIV infection was sex with a man (49.1%); 19.1% reported both sex with a man and injection drug use, and 12.7% reported injection drug use only. Seventy-five women indicated that they had become infected through sex with a man, with or without injection drug use. Of these, 65 indicated whether or not this was the result of sexual assault or rape; 8 (12.3%) answered affirmatively. Of the 81 women who responded to the question regarding prior sexual assault or abuse, 43 (53.1%) reported being sexually assaulted as an adult, 35 (43.2%) reported being sexually abused as a child, and 22 (27.2%) reported being sexually abused or assaulted both as a child and as an adult. Women who were sexually abused as a child were more likely than those who were not abused as a child to have injection drug use as a risk factor (54.3% v. 7.5%). Menstrual cycle changes were reported by 70.1% of the respondents. Most women stated that they had not received adequate pre- or post-test counselling, and 47.0% were not satisfied with their doctor''s care. Psychosocial concerns identified to be of greatest importance were financial problems, lack of intimacy or satisfying sexual relationship, and fear of rejection or discrimination. CONCLUSION: Several important concerns for HIV-positive women were identified, including dissatisfaction with medical care, fear of discrimination, violence and abuse, and poverty.     

Bullying among medical students in a Saudi medical school

ABSTRACT: BACKGROUND: Bullying and sexual harassment of medical students by their teachers appears to be widespread phenomenon. However, nothing is published about its prevalence in conservative countries such as Saudi Arabia. This survey aims to ascertain the extent of these mistreatments among students in a Saudi medical school. FINDINGS: A cross-sectional questionnaire survey was conducted on a group of 542 clinical years' medical students in a Saudi medical school to explore students' perceptions of their educational environment including exposure to different kinds of bullying. Bullying was defined as "a "persistent behaviour against a medical student that is intimidating, degrading, offensive or malicious and undermines the confidence and self- esteem of the recipient". Results revealed that more than one quarter (28.0 %) of the surveyed students reported exposure to some sort of bullying during their clinical . Ninety percent of the reported insults were verbal, 6 % sexual and 4 % physical. Males were more exposed but difference was not statistically significant. CONCLUSIONS: Bullying among Saudi medical students is an existing problem. A policy against bullying and harassment should be adopted in all of medical colleges to monitor this phenomenon and support students who have been bullied.     

Bullying of Medical Students in Pakistan: A Cross-Sectional Questionnaire Survey

Background

Several studies from other countries have shown that bullying, harassment, abuse or belittlement are a regular phenomenon faced not only by medical students, but also junior doctors, doctors undertaking research and other healthcare professionals. While research has been carried out on bullying experienced by psychiatrists and psychiatry trainees in Pakistan no such research has been conducted on medical students in this country.

Methodology/Principal Findings

We conducted a cross-sectional questionnaire survey on final year medical students in six medical colleges of Pakistan. The response rate was 63%. Fifty-two percent of respondents reported that they had faced bullying or harassment during their medical education, about 28% of them experiencing it once a month or even more frequently. The overwhelming form of bullying had been verbal abuse (57%), while consultants were the most frequent (46%) perpetrators. Students who were slightly older, males, those who reported that their medical college did not have a policy on bullying or harassment, and those who felt that adequate support was not in place at their medical college for bullied individuals, were significantly more likely to have experienced bullying.

Conclusion

Bullying or harassment is faced by quite a large proportion of medical students in Pakistan. The most frequent perpetrators of this bullying are consultants. Adoption of a policy against bullying and harassment by medical colleges, and providing avenues of support for students who have been bullied may help reduce this phenomenon, as the presence of these two was associated with decreased likelihood of students reporting having being bullied.     

Intraracial harassment on campus: explaining between- and within-group differences

Using the National Longitudinal Survey of Freshmen (NLSF), we examine both between- and within-group differences in the odds of feeling intraracially harassed. Specifically, we investigate the effects of colleges’ and universities’ racial composition as well as the nature of students’ associations with non-group members, including involvement in racially homogeneous campus organizations, ethnoracial diversity of friendship networks, and interracial dating. Our findings suggest that although college racial composition appears to have little effect on experiencing intraracial harassment, the nature of students’ involvement with other-race students matters a great deal. For all groups, interracial dating increased odds of harassment. Among black and white students, more diverse friendship networks did as well. And among Asian and Latino students, involvement in any racially homogeneous campus organization was associated with increases in reports of intraracial harassment. Thus, we propose a baseline theoretical model of intraracial harassment that highlights the nature of students’ associations with outgroups.     

Career Preferences of First-year Students at Canadian Medical Schools, 1966-67 to 1968-69

The principal findings of this study of the career preferences of first-year Canadian medical students were:Over 70% of the first-year students expressed a preference for specialty practice, with only 20% oriented towards practice as a family practitioner.There were considerable differences between the medical schools in the proportion of medical students preferring general practice, ranging from less than 10% at McGill to nearly 33% at Queen''s.Nearly one-third of the students stated that they preferred primarily salaried practice. These students were largely those who preferred specialty practice or a career in an area such as public health or research.Nearly 70% of the students looked for a career with part-time teaching, while 8% preferred a full-time teaching career.Only 1% preferred a full-time research career although 90% expected to have at least some research involvement.Students from smaller communities were more likely to express a preference for general practice than those from large urban areas.Men and women had similar practice preferences in terms of general practice and clinical specialty, but significantly more women than men preferred a career in salaried practice. Significantly fewer women expressed a preference for major involvement in either teaching or research.     

Animal abuse in Massachusetts: a summary of case reports at the MSPCA and attitudes of Massachusetts veterinarians

This article reports information abstracted from 200 randomly sampled animal abuse complaints that the Massachusetts Society for the Prevention of Cruelty to Animals received in 1996, along with the results of 1 10 surveys that Massachusetts veterinarians completed concerning their experience with and attitudes and perceptions of animal mistreatment. In 1996, there were a total of 4,942 complaints of animal mistreatment, or 2.2 complaints per 1,000 households in Massachusetts. The majority of sampled complaints involved dogs (69.5%), cats (21.5%), or both. Almost all complaints involved husbandry-related neglect (62.0%), medical neglect (26.0%), or both. A violation of the law was observed by the investigating officer in 75 (37.5%) cases. The majority (78.9%) of veterinarians reported having observed at least 1 instance of animal abuse in their patients, although few encountered more than 5 cases (16.4%) during their years of practice. Almost all respondents (93.6%) agreed that veterinarians have an ethical responsibility to report suspicions of abuse, but a smaller number (44.5%) believed that this responsibility should be mandated.     

Sexual harassment of a king penguin by an Antarctic fur seal

Males of gregarious pinnipeds are often aggressive to conspecifics and sexual coercion of females is commonplace. Males of some pinniped species have been known to attempt interspecific copulation, occasionally being successful in producing hybrid offspring. The most extreme case of interspecific sexual coercion reported concerned species from different families. We report a case of interspecific sexual harassment bridging the rank of vertebrate class.     

Topics to ponder: Part-time practice and pay parity

Background: The medical profession has undergone a significant demographic change, with a dramatic increase in the number of women applying to medical school and practicing medicine.Objectives: In recognition of the changing demographics in the medical profession, the American Medical Association's Women Physicians Congress (AMA-WPC) conducted a members' survey to identify the issues affecting women physicians and to ascertain certain practice characteristics.Methods: In 2008, an e-mail survey link was sent to a randomly selected nationwide sample of 4992 WPC members, and a second, identical survey was sent to 596 female AMA members, utilizing the Epocrates database (Epocrates, Inc., San Mateo, California). Two e-mail reminders were sent for the first survey, which had a 15% response rate. A quota of 148 physicians was received within 4 days and was utilized to interpret results from the second survey.Results: Achieving work-life balance was a significant concern for 91% of the respondents (n = 884). Half of the respondents believed that pay is gender neutral, and 28% indicated that they were “somewhat or very concerned about sexual harassment”. When queried regarding practice patterns, 29% of respondents indicated that they had worked part-time at some point during their careers.Conclusions: In this survey, women physicians indicated that gender pay disparity and sexual harassment remain important issues in the medical profession. Less than a third of respondents had ever worked part-time, which should be a consideration for physician workforce studies. Barriers to part-time practice may exist.     

Trade‐offs in female signal apparency to males offer alternative anti‐harassment strategies for colour polymorphic females

Colour polymorphisms are known to influence receiver behaviour, but how they affect a receiver's ability to detect and recognize individuals in nature is usually unknown. I hypothesized that polymorphic female damselflies represent an evolutionary stable strategy, maintained by trade‐offs between the relative apparency of morphs to male receivers. Using field experiments on Enallagma hageni and focal studies of E. hageni and Enallagma boreale, I tested for the first time the predictions that (i) green heteromorphs and blue andromorphs gain differential protection from sexual harassment via background crypsis and sexual mimicry, respectively, and (ii) female morphs behaviourally optimize their signal apparency to mate‐searching males. First, based on male reactions elicited by females, against a high‐contrast background, the two morphs did not differ in being detected by males, and once detected, they did not differ in being recognized (eliciting sexual reactions). However, on green ferns, heteromorphs were less likely to be detected (elicited only fly‐bys) than andromorphs, but once detected, the morphs did not differ in being recognized. In contrast, when perched on a dowel with two male signal distractors, andromorphs were detected less often, and once detected, they were recognized less often than heteromorphs. Second, in fields where females foraged, andromorphs perched higher on vegetation than heteromorphs and were more often in the vicinity of males. Neither harassment rates nor evasive behaviours differed between morphs. Males aggregated in high density near shore where solitary females were rare. Equilibrium frequencies of these and other colour morphs should reflect the relative ease with which receivers detect and recognize them in the context where they are encountered.     

Do students' attitudes toward women change during medical school?

BACKGROUND: Medical school has historically reinforced traditional views of women. This cohort study follows implementation of a revitalized curriculum and examines students'' attitudes toward women on entry into an Ontario medical school, and 3 years later. METHODS: Of the 75 students entering first year at Queen''s University medical school 70 completed the initial survey in September 1994 and 54 were resurveyed in May 1997. First-year students at 2 other Ontario medical schools were also surveyed in 1994, and these 166 respondents formed a comparison group. Changes in responses to statements about sex-role stereotypes, willingness to control decision-making of female patients, and conceptualization of women as "other" or "abnormal" because they are women were examined. Responses from the comparison group were used to indicate whether the Queen''s group was representative. RESULTS: Attitudinal differences between the primary group and the comparison group were not significant. After 3 years of medical education students were somewhat less accepting of sex-role stereotypes and less controlling in the doctor-patient encounter. They continued, however, to equate adults with men and to see women as "not adult" or "other." Female students began and remained somewhat more open-minded in all areas studied. INTERPRETATION: A predicted trend toward conservatism was not seen as students became older, more aware and closer to completion of medical training, although they continued to equate adults with male and to see women as "other." Findings may validate new curricular approaches and increased attention to gender issues in the academic environment.     

Sexual interference in the Golden snub-nosed monkey (Rhinopithecus roxellana): a test of the sexual competition hypothesis in a polygynous species

Sexual interference (SI), which is defined as any disturbance directed to a mating pair by other individuals, has been reported in several primate species. It is widely suggested that successful harassers experience improved mating success by increasing their access to reproductive partners as well as by reducing the mating success of rivals. Although theories of primate sexual conflict highlight male intra-sexual mating competition, females also are reported to actively disrupt copulations between mating partners. In this study, we investigated SI in a multilevel troop of Golden snub-nosed monkeys (Rhinopithecus roxellana) inhabiting the Qinling Mountains, China. Behavioral observations of 11 one-male units (OMU) that comprised the multilevel troop were conducted from September 2007 to May 2008. During this period 17.1% of 652 documented intra-OMU sexual encounters were characterized either by mild or aggressive forms of harassment. Sexual harassment was typically performed by a single individual (91.9%), and in 75.7% of cases the harasser was an adult or sub-adult female. The frequency of female harassment was positively correlated with the number of adult and sub-adult females residing in an OMU, and resulted in a significant decrease in matings ending in ejaculation. We found that the amount of SI a female received was not a significant predictor of her reproductive success. However, females who conceived during the mating season directed higher levels of harassment at other females than females who did not conceive. We evaluate the strength of the sexual competition hypothesis and the hormonally modulated aggression hypothesis in explaining patterns of SI in female Golden snub-nosed monkeys.     

A curriculum on physician-patient sexual misconduct and teacher-learner mistreatment. Part 2: Teaching method.

Medical educators have become increasingly aware of the need for health care professionals to receive more training about the causes and consequences of physician-patient sexual misconduct and teacher-learner mistreatment and harassment. A curriculum in use at the University of Toronto includes a didactic component, consisting of lectures, and an experiential component, consisting of a workshop. This article concerns how, by discussing case vignettes designed to illustrate salient points, the participants have an opportunity to consider their responses in actual clinical and teaching situations. Evaluation of the course by 373 participants shows that the curriculum is considered acceptable and is likely to be of benefit. Of the course participants, 54% (15/28) of those attending the course for faculty and 39% (133/345) of those at subsequent courses stated that they would change their clinical and teaching practices in positive ways as a result of attending. A further 38% (130/345) stated that they already practised in a manner congruent with the model discussed.     

Sociosexuality as predictor of sexual harassment and coercion in female and male high school students

Sexual harassment and coercion have mainly been considered from a sex difference perspective. While traditional social science theories have explained harassment as male dominance of females, the evolutionary perspective has suggested that sex differences in the desire for sex are a better explanation. This study attempts to address individual differences associated with harassment from an evolutionary perspective. Considering previous research that has found links between sociosexual orientation inventory (SOI) and harassment, we consider whether this association can be replicated in a large, representative sample of high school students (N=1199) from a highly egalitarian culture. Expanding the previous studies which mainly focused on male perpetrators and female victims, we also examine females and males as both perpetrators and as victims. We believe that unrestricted sociosexuality motivates people to test whether others are interested in short-term sexual relations in ways that sometimes might be defined as harassment. Furthermore, unrestricted individuals signal their sociosexual orientation, and while they do not desire all individuals that react to these signals with sexual advances, they attract much more sexual advances than individuals with restricted sociosexual orientations, especially from other unrestricted members of the opposite sex. This more or less unconscious signaling thus makes them exploitable, i.e., harassable. We find that SOI is a predictor for sexual harassment and coercion among high school students. The paper concludes that, as expected, unrestricted sociosexuality predicts being both a perpetrator and a victim of both same-sex and opposite-sex harassment.     

Anatomy dissections and student experience at Irish universities, c.1900s-1960s

Utilising the unique source of articles, poems, stories and cartoons from student magazines from all of the Irish universities, in addition to the memoirs of Irish doctors, and the accounts of correspondents, this paper will discuss the Irish student’s experience of anatomy in the early twentieth century. For many medical students, anatomy dissections were seen as a rite of passage, while one student at Queen’s College Belfast claimed that ‘the dissecting-room is to the student a club, a smoke room, common room research room—one in all.’ However, the dissecting rooms of Irish medical schools were often rife with bawdy conversation, sexual undertones and black humour. Recognising this, following the admission of women to Irish medical schools from the 1880s, university authorities constructed separate dissecting rooms for the women students, and part of this paper will investigate why this separation occurred.I will examine the Irish dissecting room as a centre of learning and integral part of student experience in the period. The paper will suggest that the black humour and pranks that were commonplace within the context of the dissecting room acted as a means for students to reconcile their fears and anxiety about dissecting.     

Gender differences in sexual jealousy: Adaptionist or social learning explanation?

It has often been speculated, and some evidence suggests, that men and women differ in the elicitation of jealousy: Men appear to be more likely than women to become upset over threats to sexual exclusivity; whereas women are more likely than men to react negatively to potential loss of partner time and attention. Both adaptionist and traditional social learning theories have been used to explain these apparent gender differences. In the present article we outline both explanations and review the relevant psychological literature on gender differences in the elicitation of jealousy. We propose that the difference in men's and women's psychological mechanisms for elicitation of jealousy is best characterized (at least in this culture) as a greater sensitivity among men to cues indicative of possible sexual infidelity rather than greater emotional upset in response to the occurence of extradyadic sex on the part of one's mate. We also provide data testing a traditional social learning explanation for the elicitation of jealousy. Results of a survey administered to college students (N = 223) demonstrate the subtle nature of gender differences in the elicitation of jealousy within this culture. Men and women were most likely to differ (in the hypothesized directions) when items pertained to concern over a partner's potential extradyadic sex rather than to reactions to sexual infidelity that is suspected to have already occurred. Although men reported placing more value on sexual activity within dating relationships and women reported placing more value on emotional intimacy, these ratings of relationship rewards did not explain the gender differences in reported jealousy. Results failed to support a traditional social learning explanation of jealousy and are discussed with regard to evolutionary theory and directions for future research.