Discrimination, harassment, and intimidation amongst otolaryngology—head and neck surgeons in Canada

Abstract

Background Understanding mistreatment within medicine is an important first step in creating and maintaining a safe and inclusive work environment. The objective of this study was to quantify the prevalence of perceived workplace mistreatment amongst otolaryngology—head and neck surgery (OHNS) faculty and trainees in Canada. Methods This national cross-sectional survey was administered to practicing otolaryngologists and residents training in an otolaryngology program in Canada during the 2020–2021 academic year. The prevalence and sources of mistreatment (intimidation, harassment, and discrimination) were ascertained. The availability, awareness, and rate of utilization of institutional resources to address mistreatment were also studied. Results The survey was administered to 519 individuals and had an overall response rate of 39.1% (189/519). The respondents included faculty (n = 107; 56.6%) and trainees (n = 82; 43.4%). Mistreatment (intimidation, harassment, or discrimination) was reported in 47.6% of respondents. Of note, harassment was reported at a higher rate in female respondents (57.0%) and White/Caucasian faculty and trainees experienced less discrimination than their non-White colleagues (22.7% vs. 54.5%). The two most common sources of mistreatment were OHNS faculty and patients. Only 14.9% of those experiencing mistreatment sought assistance from institutional resources to address mistreatment. The low utilization rate was primarily attributed to concerns about retribution. Interpretation Mistreatment is prevalent amongst Canadian OHNS trainees and faculty. A concerning majority of respondents reporting mistreatment did not access resources due to fear of confidentiality and retribution. Understanding the source and prevalence of mistreatment is the first step to enabling goal-directed initiatives to address this issue and maintain a safe and inclusive working environment. Graphical Abstract

Harassment in the headache field: a global web-based cross-sectional survey

“…This means that speaking out and trying to enact change within the profession is extremely hard. Frequently reported reasons for under-reporting also include belief that no action will be undertaken, fear of consequences and negative impact on own career, stigma, fear of worsening the situation, and not knowing how to report (22,23,28). Another contributing factor is the lack of a clear definition.…”

“…In addition to the high prevalence of sexual harassment, our data demonstrate that almost half of headache professionals experience harassment that was not of a sexual nature. Unfortunately, a hostile work environment is frequently reported across different medical and healthcare disciplines (16,23,26,31). Nonetheless, these data come at a crucial timepoint, as harassment and the “toxic hierarchical” culture in medicine are being openly challenged.…”

“…This contributes towards the fact that people who experience work-based sexual harassment seldom file complaints or report their experiences (21). Moreover, other factors such as stigma, fear of consequences and difficulties in proving allegations all play important roles in this (22,23).…”

Microaggressions in European versus American Workplace Environments of Otolaryngology‐Head and Neck Surgery

“…[9][10][11][12] To date, many works have been conducted in North America regarding microaggressions and discriminations in Otolaryngology. 5,7 However in Europe few studies have been published in Otolaryngology on the topic, although there has been a demonstrable increase in interest and reports from other specialties, such as general surgery. 4,13 The aims of this study are to both characterize and assess the prevalence of microaggressions in Otolaryngology in Europe in comparison with the United States.…”

“…Professional societies and healthcare institutions have increased their efforts to identify microaggressions and discriminations, especially regarding Black, Indigenous, people of color, or BIPOC individuals who often bear the brunt of this aggressive behavior 1–3 . Within the medical community, the surgical field is commonly seen as having a conservative culture and the surgical subspecialty of Otolaryngology‐Head and Neck Surgery remains an example 4,5 . The Otolaryngology‐Head and Neck Surgery is predominantly comprised of White and male members, with underrepresentation of females and non‐White practitioners in academic positions 6 .…”