What Makes Academic Physicians Satisfied With Their Job?

MedicalResearch.com Interview with:

Arabella L. Simpkin,  MD, MMScAssociate Director, Center for Educational Innovation and Scholarship, MGHAssociate Program Director, Education and Curriculum, Internal Medicine Residency, MGHInstructor in Medicine, Harvard Medical SchoolBoston, MA 02114

Dr. Simpkin

Arabella L. Simpkin,  MD, MMSc
Associate Director, Center for Educational Innovation and Scholarship, MGH
Associate Program Director, Education and Curriculum, Internal Medicine Residency, MGH
Instructor in Medicine, Harvard Medical School
Boston, MA 02114

MedicalResearch.com: What is the background for this study?

Response: The academic health care environment has changed in unprecedented ways over several decades, with mounting evidence that faculty are becoming increasingly more unhappy, dissatisfied, and burnt out in their work. Concern for faculty wellbeing is high, with much speculation about causes of burnout. Comprehending what affects satisfaction at work in academic health care centers is critically important to stem this epidemic of discontent. For physicians, satisfaction has been reported to be associated with quality of care delivered, particularly as measured by patient satisfaction; faculty retention and job satisfaction are intricately linked, with dissatisfied physicians more likely to leave the profession and to discourage others from entering.

Other industries that have suffered similar rises in employee discontent have found that demonstration of respect is the most important leadership behavior in improving employees satisfaction. To our knowledge this factor has not been looked at in healthcare professionals. To address this gap, we sought to determine key variables influencing satisfaction at work for faculty in a large academic medical center in the United States.

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Sexual Harassment in Academic Medicine Affects Both Women and Men

MedicalResearch.com Interview with:

Sabine Oertelt-Prigione, MD, MSc Professor (Strategic Chair) of Gender in Primary and Transmural Care Department of Primary and Community Care Radboud University Medical Center

Dr. Oertelt-Prigione

Sabine Oertelt-Prigione, MD, MSc
Professor (Strategic Chair) of Gender in Primary and Transmural Care
Department of Primary and Community Care
Radboud University Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This publication is a part of the WPP (Watch, Protect, Prevent) Study conducted between 2014 and 2017 at Charité – Universitaetsmedizin in Berlin, Germany. The project was designed to achieve three goals: a) acquire information about the prevalence of sexual harassment in academic medicine, b) develop and implement specific preventative measures and c) design and adopt a workplace policy against sexual harassment. The two latter goals have been achieved and this manuscript describes the findings that prompted their adoption.

In our study we carefully dissected the harassment experiences of physicians working in our tertiary referral center. Verbal harassment throughout medical careers appears as a very common phenomenon that almost 70% of women and men experience at some point. Physical harassment is less common. While colleagues appear as the main perpetrators for both sexes, women report more frequently harassment by their superiors. Among the structural factors potentially associated with harassment, we only identified strong hierarchies. 

MedicalResearch.com: What should readers take away from your report?

Response: First, we show that although the perpetrator profiles differ, both women and men in our study sample are significantly affected by sexual harassment. Second, our results display a gradient of harassment experiences and their prevalence, i.e. the verbal and non-physical forms are more common than physical forms. We argue that tolerance of non-physical forms of misconduct will increase the risk for physical forms by fostering a belief of impunity. Third, in our sample, strong hierarchies associated with an increased likelihood of experiencing harassment in both females and males.

Overall, this data shows that sexual harassment is not an action perpetrated by a single individual, but has a systemic dimension, which needs to be addressed through cultural change. Only measures targeting communication culture, formal structures and interactions in academic medicine will lead to change. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: The investigation of sexual harassment is a complicated matter and should be addressed in detail. In order to design effective prevention measures, we need to know exactly what people have experienced. Hence, a simple question such as “Have you ever experienced sexual harassment?” within a statutory survey will most likely not help much in defining further steps.

The connection between communication patterns, hierarchies and harassment was very apparent in our sample and this area needs further investigation.

Last, the fact that men are also significantly affected emphasizes that this is not a women´s issue but a phenomenon that needs to be addressed to improve the working conditions for all healthcare providers.

Disclosures: Sabine Oertelt-Prigione received funding from the German Ministry of Education and Research, the Charité Foundation, the Hans Boeckler Foundation and the Equal Opportunities Program of the City of Berlin. She has provided expert testimony on the issue of sexual harassment to the German Federal Antidiscrimination Agency and the German Parliament. She is a pro-bono expert advisor for ASTIA.

Citation:

Jenner S, Djermester P, Prügl J, Kurmeyer C, Oertelt-Prigione S. Prevalence of Sexual Harassment in Academic Medicine. JAMA Intern Med. Published online October 03, 2018. doi:10.1001/jamainternmed.2018.4859 

Oct 3, 2018 @ 6:20 pm

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Only a Quarter of Medical Grand Round Speakers Are Women

MedicalResearch.com Interview with:
Julie R. Boiko, MD, MS
Resident Physician, PGY1
Department of Pediatrics
University of California, San Francisco

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Grand rounds is an over 100-year-old tradition in US medical school clinical departments of recurring, expert-delivered lectures to update physicians and physicians-in-training on recent advances in relevant medicine. We wanted to determine whether gender representation of speakers at grand rounds aligns with the gender distribution of people typically represented in grand rounds audiences — faculty, residents, and medical students — by clinical specialty according to national academic medical trainee and workforce statistics.

We chose to focus on grand rounds speakers as visible representations of women in academic medicine. This is important because, despite women and men entering medicine at comparable rates, women are much more likely to depart academic medical careers. As current and recent medical students, we considered that consistent exposure to successful female role models in grand rounds speaking venues may positively reinforce women trainees’ desires to continue in academic medical careers.

We found that the people at the podiums do not resemble the people in the audience. Only 26% of grand rounds speakers are women. Even accounting that some clinical specialties contain few women faculty and residents, grand rounds speakers in most specialties we studied were statistically less likely to be women as compared to faculty and residents. Across the specialties, grand rounds speakers are 44% less likely than medical students, 39% less likely than residents, and 21% less likely than faculty to be women.

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