Medicine as a discipline is constantly changing. Interprofessional collaboration is on the rise, requiring more complex teamwork and communication skills. There are still steep professional hierarchies and discrimination and harassment commonly occur. While most perpetrators are senior medical staff, doctors in training also experience these behaviours from other health workers, patients and their families. Unfortunately, learners are also exposed to other forms of occupational violence. The formal curriculum codifies professionalism into competency skills which can be taught and examined, but it is the hidden curriculum, shaped by experience, that instils professional attitudes and values. Many attempts have been made to reduce the risk of sexual harm, including training learners to recognise and respond to inappropriate behaviour, but none have ensured a psychologically safe workplace for all doctors. In this chapter, we explore the role of medical training in shaping the culture of medicine. Doctors in training are still developing their professional identities, and their experiences in training shape the way they work, and who they aspire to be as a professional. Without a vocabulary to discuss their discomforts and emotional needs, junior doctors are left isolated and vulnerable, hidden in a culture of silence.

This chapter introduces the three major themes of the book: relative clauses, Proto-Indo-European and syntax.

Medicine is a highly complex profession which requires students to acquire a broad range of competencies. Apart from knowledge and kinaesthetic skills, they must also become proficient in the art of medicine, learning to communicate effectively in different clinical and social environments. This is not a simple task for the learners, and it requires deep educational competencies from the senior colleagues and peers involved in clinical training. Medical training predominantly occurs in healthcare workplaces, which are socio-culturally diverse. Doctors in training need to balance the need to learn with service obligations, whilst navigating each workplace’s cultural norms and this can be a significant challenge.

Medical educators modify the risks of sexual harassment by leading initiatives around professionalism. This includes developing professionalism curriculum, teaching and assessing professionalism competencies, managing learning environments, and leading teaching teams. In this chapter, we examine the role of medical education in teaching, assessing and remediating interpersonal competencies and attitudes. In doing so, we recognise different forms of power, conscious and unconscious, and propose strategies for understanding and managing risk.

We are academics from Austria researching discrimination and harassment in academic medicine, particularly in medical students. We, a psychologist researching gender-specific and intersectional aspects in violence against women, gender-based violence and discrimination, a former medical student interested in social and gender equality and with insights on medical education, and a retired professor specialized in gender medicine, combined our perspectives on sexualized harassment and discrimination in academic medicine. This chapter illustrates our reflections and discussion on research findings about sexualized harassment in academic medicine. Inspired by findings from several studies, we illustrate a fictional case study on sexualized harassment and discrimination in academic medicine in Austria and interpret this case through theoretical and empirical lenses on sexual harassment, violence, and power. Sexualized harassment in academic medicine shares many commonalities across different contexts. Even though the Austrian context may differ from other countries in its societal structures, population, social forces, legislation and so forth, internationally, medical education and academic medicine exhibit structures, which enable sexualized harassment and discrimination. With this chapter we contribute to eliciting context- and medicine-specific aspects that hinder and enable harassment and discrimination in academic medicine and medical education.

We are academics from Austria researching discrimination and harassment in academic medicine, particularly in medical students. We, a psychologist researching gender-specific and intersectional aspects in violence against women, gender-based violence and discrimination, a former medical student interested in social and gender equality and with insights on medical education, and a retired professor specialized in gender medicine, combined our perspectives on sexualized harassment and discrimination in academic medicine. This chapter illustrates our reflections and discussion on research findings about sexualized harassment in academic medicine. Inspired by findings from several studies, we illustrate a fictional case study on sexualized harassment and discrimination in academic medicine in Austria and interpret this case through theoretical and empirical lenses on sexual harassment, violence, and power. Sexualized harassment in academic medicine shares many commonalities across different contexts. Even though the Austrian context may differ from other countries in its societal structures, population, social forces, legislation and so forth, internationally, medical education and academic medicine exhibit structures, which enable sexualized harassment and discrimination. With this chapter we contribute to eliciting context- and medicine-specific aspects that hinder and enable harassment and discrimination in academic medicine and medical education.

We are academics from Austria researching discrimination and harassment in academic medicine, particularly in medical students. We, a psychologist researching gender-specific and intersectional aspects in violence against women, gender-based violence and discrimination, a former medical student interested in social and gender equality and with insights on medical education, and a retired professor specialized in gender medicine, combined our perspectives on sexualized harassment and discrimination in academic medicine. This chapter illustrates our reflections and discussion on research findings about sexualized harassment in academic medicine. Inspired by findings from several studies, we illustrate a fictional case study on sexualized harassment and discrimination in academic medicine in Austria and interpret this case through theoretical and empirical lenses on sexual harassment, violence, and power. Sexualized harassment in academic medicine shares many commonalities across different contexts. Even though the Austrian context may differ from other countries in its societal structures, population, social forces, legislation and so forth, internationally, medical education and academic medicine exhibit structures, which enable sexualized harassment and discrimination. With this chapter we contribute to eliciting context- and medicine-specific aspects that hinder and enable harassment and discrimination in academic medicine and medical education

This chapter examines how medical workplaces – as material places and as institutions - protect or undermine the physical and emotional lives of the doctors who work there. Workplaces include hospitals, ambulatory clinics, locum settings, and precarious workplaces such as international humanitarian medical work, and newer, non-material workplaces such as telemedicine. Dominance and sexual harassment can occur in the interstices of all these workplaces, and sometimes in the full view of others.

‘Dark dinosaur infested depths of the world of GP politics’, ‘Female doctors groped, propositioned and harassed by senior male colleagues in BMA’, were headlines which hit the UK medical and national press in 2019 and shook the medical establishment. In this chapter Dr Clarissa Fabre, a family physician, outlines what happened at the British Medical Association (BMA), the resulting investigation and report (The Daphne Romney Report) and its recommendations for the future. She served on the BMA General Practitioners’ Committee from 2004 to 2012. As the Medical Women’s International Association representative to the World Health Organisation (2012-2019), she developed a long-term interest in the prevention of violence against women and girls, and sexual harassment. Despite numerous protocols, regulations and initiatives, sexism and sexual harassment in medicine and in society remain rife.

Introduction

Haiti, 2004; USA, 2005; Myanmar, 2008; Pakistan, 2010; Thailand, 2011; Philippines, 2013; Brazil, 2014; Caribbean, 2017; Tonga, 2018; India, 2018; Mozambique, Zimbabwe, and Malawi, 2019; Australia, 2019–2020; Germany, 2021; Pakistan, 2022; Europe and the United Kingdom (UK), 2022; China, 2022; the United States (US), 2023; Libya, 2023; Kenya and Tanzania, 2024; Brazil, 2024; Poland, 2024; Bangladesh, 2024.

In recent decades, different regions of the world have experienced disasters that are increasingly attributable to the climate crisis (cf. IPCC 2021).1 These disasters, though differing in scale and geographical location, share common characteristics. In all these cases, those affected are at varying degrees of risk, both globally and in the place where the disaster occurred.2 In all of these cases, the slippery slope of vulnerability correlates closely with prior marginalization based on race, gender, class, education, and other factors (cf. Méjean et al 2024; Cappelli, Costantini, and Consoli 2021; Belkhir and Charlemaine 2007; Giroux 2006). These disasters are not only ‘non-natural’ because they occur in the context of anthropogenic climate change, but also because they overlap with politically determined preconditions (cf. Dawson 2010, 317). As the human rights activist and actor Danny Glover graphically illustrated in the aftermath of Hurricane Katrina (cited in Akuno 2006, 34),

The discourse on sexual harassment in Malaysia started long ago in 1985 by women activists and academics. Finally, Malaysia’s Dewan Rakyat (House of Representatives) passed the Anti-Sexual Harassment Bill 2021 on 18th October 2022, two decades after it was drafted. The information in this chapter is based on the effort of three people with different backgrounds. They are united given similar interests to understand and create further awareness around sexual harassment, particularly among medical professionals. Sajar Othman is a professor in primary care medicine with a particular interest in violence against women and trauma care. Betty Yeoh, a strong advocate against sexual harassment, is a founding member of the All Women’s Action Society (AWAM), a feminist NGO in Malaysia. She is also a registered counsellor who uses her skills to support survivors. Christine Selvaraj is a primary care physician who is passionate about advocating a healthier lifestyle for her patients and her students.

This chapter provides a loose, non-linear history of the term ‘workplace sexual harassment’, exploring the many ways it has been conceptualised, problematised and managed. First, it describes how the term ‘sexual harassment’ developed through advocacy for real-world change, from grassroots activism to legal scholarship. Second, it outlines theories of sexual harassment guiding empirical inquiry and understanding in social sciences. Third, it explores the ways that changing the context in which a term is used can also change its function. The chapter concludes by discussing implications for implementing these critical approaches to bring about change in the context of workplace sexual harassment in medicine.

This section presents the author’s conclusions and offers some outlook for further research.

This chapter has been written by four medical doctors (Jane, Maria, Sharon and Ketty), a gender specialist (Grace) and a state advocate (Chali). There have always been some discussions among medical students and doctors about the occurrence of sexual harassment in the medical fraternity. However, without any published evidence, it would appear as though it is gossip or name tarnishing to some. This chapter begins with a real-life narration of Maria’s experience of sexual harassment when she was a young doctor. We also delved into investigating sexual harassment among Zambian female doctors by utilizing an anonymous online questionnaire that was sent via the Medical Women Association of Zambia (MWAZ) mailing platform. Eight brave doctors responded to the call; their stories will leave you in tears. This book has given us an opportunity to shed light on sexual harassment and break the silence.

Sexual harassment in the medical workplace is a complex, multifaceted problem that needs evidence-based solutions. Medicine is, of course, not unique in having to manage this. For decades, consciousness-raising groups have created spaces to find ways to speak the unspeakable, raising awareness of gender-based violence at work and at home, in order for survivors to begin to heal. Hashtags such as such as #MeToo, #MeoQueridoProfesor, and #UtanTystnadsplikt perform this function in a digital landscape, exposing entrenched toxicity across a range of workplaces, and agitating for legislative and political reform in a number of global contexts.