Lois Margaret Nora

Stories from the field: students' descriptions of gender discrimination and sexual harassment during medical school.

Purpose Previous studies have documented the prevalence of gender discrimination and sexual harassment during medical training, but very few have examined the behaviors that students perceive as discriminatory or harassing. The authors addressed this lack of information by examining graduating medical students’ written descriptions of personal experiences with such behaviors during medical school. Method The authors reviewed the responses of graduating seniors at 12 U.S. medical schools to a questionnaire, administered in 2001–02, that asked them to provide written descriptions of their personal experiences with gender discrimination and sexual harassment. Seven response categories were created on the basis of recurring themes: educational inequalities; stereotypical comments; sexual overtures; offensive, embarrassing, or sexually explicit comments; inappropriate touching; sexist remarks; and not classifiable. The three authors examined the students’ written accounts and placed each into one or more of the categories. Results Of the students’ responses, 290 (36.6%) contained 313 written descriptions of personal experiences that the students perceived as either discriminatory or harassing. The most frequently reported experiences involved educational inequalities; experiences in this category were reported more frequently by men than by women. All other categories of experiences were reported more frequently by women. Conclusions The results support earlier findings of the prevalence of gender discrimination and sexual harassment during undergraduate medical education. Perhaps formal antiharassment policies should provide examples of unacceptable behavior that are based on categories such as those revealed by this analysis. Perhaps, too, medical students’ comments could be used to develop educational interventions for physicians in supervisory positions.

The 21st century faculty member in the educational process--what should be on the horizon?

One of Abraham Flexners legacies was the concept of a professional faculty community responsible for teaching, scholarly work, and the creation and nurturing of the academic environment in medical schools. Dramatic shifts in society, health care, and educational practice have occurred over the century since Flexners report, and these shifts have resulted in changes and challenges for medical school faculty. Fundamental principles that were articulated in Flexners work remain relevant today: medicine is a profession, and as such is responsible for the education of the next generation of physicians; and the essential work of the medical school is the education of current and future generations of physicians. Medical schools must reconsider and restate the required characteristics and work of faculty members. Furthermore, we must develop a core faculty with primary responsibility for the educational program, the teaching of students, and the creation and nurturing of the academic environment. Enhancing the diversity of the faculty community, providing necessary faculty development, and further clarifying the forms of scholarly work in medicine are three ways that individual schools and national organizations can advance the educational mission through support of the faculty.

Does exposure to gender discrimination and sexual harassment impact medical students' specialty choices and residency program selections?

No abstract available.

Medicolegal aspects of informed consent

This article discusses informed consent and emphasizes four critical features of ethically and legally appropriate informed consent. The article also highlights some exceptions to informed consent requirements. The authors outline practical advice for avoiding litigation resulting from consent issues.

Academic Medicine Gets a Poor Report Card—what Are We Going to Do?

When I was growing up, report cards were very important in our family. Expectations for performance were based on our parents’ estimation of our capabilities. Reasons for meeting those performance expectations were known and ranged from getting into a good college to justifying the expense of tuition to not disappointing our parents. Grades were awaited with great anticipation and scrutinized not only for academic performance but also for indications of effort and positive progress. Good grades were recognized; bad grades, discussed. The most serious discussions were reserved for reports that indicated a lack of positive progress or effort. When necessary, remedial plans —everything from set study hours to tutoring to loss of privileges—were put into place. In this Commentary, I share my thoughts about another type of report card. Seven years ago, the AAMC formed a committee to determine why the number of women selected for leadership positions in academic medicine was failing to keep pace with either the desire to achieve gender balance or the availability of talented women. A plan of action was proposed, including the formation of a project implementation committee. This month’s Academic Medicine includes this team’s findings in the form of a report card entitled ‘‘Increasing Women’s Leadership in Academic Medicine: Report of the AAMC Project Implementation Committee.’’ In this Commentary on the report, I consider four questions: (1) Why should we in academic medicine care about our performance in this area? (2) What does the report card say about our progress? (3) What should we consider as we develop remedial plans to improve our performance? Finally, (4) What will a good report card in this area include?

Expanding Educators' Contributions to Continuous Quality Improvement of American Board of Medical Specialties Maintenance of Certification.

The American Board of Medical Specialties board certification has transformed into a career-long process of learning, assessment, and performance improvement through its Program for Maintenance of Certification (MOC). Medical educators across many medical professional organizations, specialty societies, and other institutions have played important roles in shaping MOC and tailoring its overarching framework to the needs of different specialties. This Commentary addresses potential barriers to engagement in work related to MOC for medical school (MS) and academic health center (AHC) educators and identifies reasons for, and ways to accomplish, greater involvement in this work. The authors present ways that medical and other health professions educators in these settings can contribute to the continuous improvement of the MOC program including developing educational and assessment activities, engaging in debate about MOC, linking MOC with institutional quality improvement activities, and pursuing MOC-related scholarship. MS- and AHC-based educators have much to offer this still-young and continually improving program, and their engagement is sought, necessary, and welcomed.

SELECTED LEGAL ISSUES IN MOVEMENT DISORDERS

This article explores the long-standing question of whether trauma causes Parkinsons disease, and discusses the impact of informed consent and confidentiality in issues of genetic testing for Huntingtons disease. Neurologists are appropriately concerned about the legal aspects of genetic testing, and this article attempts to address that subject from a medical-legal perspective.