Student Mistreatment in the David Geffen School of Medicine

1. Student Mistreatment in the David Geffen School of Medicine Presentation to the MEC April 11, 2012 • Joyce Fried, Assistant Dean

2. Types of Mistreatment • Physical • Slapped, struck or pushed • Verbal • Yelled or shouted at, called a derogatory name, cursed or ridiculed • Sexual Harassment • Inappropriate physical or verbal advances, intentional neglect, sexual jokes, or mistreatment based on sexual orientation • Ethnic • Intentional neglect, ethnic jokes, comments, and expectations regarding stereotypical behavior • Power • Made to feel intimidated, dehumanized, or had a threat made about a recommendation, your grade, or your career

3. Percentage of Students Experiencing MistreatmentClasses of 1998-2012

4. Percentage of Students Experiencing MistreatmentBy Type, Class of 2012 • Physical • N= 12 (7.8 % ) • Verbal • N= 54 (35.1 %) • Sexual Harassment • N=17 (11.0 %) • Ethnic • N=12 (7.8 %) • Power • N= 38 (24.7 %)

5. Who is the Source of Mistreatment? • Clinical Faculty • N=55, 43. 7 % • Residents • N=42, 33.3 % • Nurses • N= 13, 10.3 % • Patient • N=8, 6.4 % • HB&D Faculty • N= 4, 3.2 % • Student • N= 2, 1.6 % • Other • N= 2, 1.6 %

6. Who is the Source of Mistreatment?

7. Where does Mistreatment Occur?

8. Examples of Comments- Physical “My hand was slapped (not gently) several times during a surgery instead of the faculty member just asking me to move it. This was not during a stressful portion of surgery. He simply didn't have the decency to ask.”

9. Examples of Comments- Verbal “I was told by my 3rd year resident to ‘never speak unless you are spoken to’, and on numerous occasions he would nod his head or elbow me and say ‘hey- remember what I told you!’ I was also made fun of repeatedly for caring about my patients. One of my patients outright endorsed suicidal ideation to me while I was left alone to pack his gaping abdominal wound, and when I mentioned it to my resident, I was made fun of for caring. I was even told ‘you know, you should really go into psych’, as an insult because I always knew about my patient's lives as well as their disease.”

10. Examples of Comments-Sexual Harassment “I had a resident grope my penis and point out the outline of his erect penis through his scrubs to me on numerous occasions while on call. He tried repeatedly to lure me to the call rooms in the basement of Cedars. Another medical student on our rotation experienced similar treatment, but we feared turning him in because of the effect it might have on our evals. Throughout the day, he made numerous explicit sexual comments and made questionable inappropriate advances at vulnerable patients who he was attracted to. It was a very uncomfortable experience.”

11. Examples of Comments- Ethnic “A faculty member made a comment during grand rounds insinuating that black and Hispanic patients specifically need to be questioned about prison history as compared to Caucasian or Asian patients.”

12. Examples of Comments- Power “Working 14 days straight and being called in an extra hour early to write notes, sending me over the 24 hour work limit; working 27 hrs on a 24 hour call and in the midst of that, having an afternoon appointment with a faculty member switched to 8PM on a normal workday…”

13. Interventions Gender and Power Abuse Committee • Statement on an Abuse-Free Environment • Policy on Prevention of Student Mistreatment • CHS Ombuds Office • Mandatory Clinical Foundations Workshop • House Staff Orientation Session • Sexual Harassment Required Module • System-Based Healthcare Module

14. Interventions Moving Forward • More specific questions on evaluations • Mechanism for addressing complaints in real time • Making consequences stick • Working with specific departments • Creating a CICare-like module