Exposure of medical students to sexism and sexual harassment and their association with mental health: a cross-sectional study at a Swiss medical school

Abstract

ObjectivesTo assess the self-reported prevalence of sexism and sexual harassment at a Swiss medical school, and to investigate their association with mental health. Research hypotheses were an association between sexism/sexual harassment and poor mental health and a higher prevalence of sexism/sexual harassment in clinical rotations.DesignCross-sectional study as a part of ETMED-L project, an ongoing cohort study of interpersonal competences and mental health of medical students.SettingSingle-centre Swiss study using an online survey submitted to medical students.ParticipantsFrom 2096 registered students, 1059 were respondents (50.52%). We excluded 26 participants (25 due to wrong answers to attention questions, and 1 who did not answer the sexism exposure question). The final sample (N=1033) included 720 women, 300 men and 13 non-binary people.MeasuresPrevalence of self-reported exposure to sexism/sexual harassment. Multivariate regression analyses of association between being targeted by sexism or sexual harassment and mental health (depression, suicidal ideation, anxiety, stress, burnout, substance use and recent mental health consultation). Regression models adjusted for gender, academic year, native language, parental education level, partnership and an extracurricular paid job.ResultsBeing targeted by sexism or sexual harassment was reported by 16% of participants with a majority of women (96%). The prevalence increased with clinical work. After adjusting for covariates, we found association between being targeted by sexism/harassment and risk of depression (OR 2.29, 95% CI 1.54 to 3.41, p<0.001), suicidal ideation (B coefficient (B) 0.37, p<0.001) and anxiety (B 3.69, p<0.001), as well as cynicism (B 1.46, p=0.001) and emotional exhaustion (B 0.94, p=0.044) components of burnout, substance use (B 6.51, p<0.001) and a recent mental health consultation (OR 1.78, 95% CI 1.10 to 2.66, p=0.005).ConclusionsSexism and sexual harassment, although less common than usually reported, are behaviours of concern in this medical school and are significantly associated with mental health.

The Sexual Harassment of Medical Students – Victims, Experiences, Impact, and Barriers to Reporting

“…Further analysis revealed that women, as well as multi-racial students, were at greater odds of being harassed by faculty and staff (McClain et al 2021). One study which examined students from all French faculties, 20% of female participants reported being victims of SH under the definition of French Law (Duba et al 2020), meanwhile another study reported 1 in 4 students experienced harassment (Barbier et al 2023). One particularly large French study reports student faced sexual harassment and aggression during their studies (Rolland et al 2022).…”

“…Meanwhile, females who reported SH experienced significant feelings of burnout (Mahurin et al 2022). Students also reported significant feelings of cynicism and emotional exhaustion (Barbier et al 2023), and guilt and progressive isolation (Babaria et al 2012).…”

“…Exposure to sexual harassment increased the odds of suicidal ideation and substance use (Barbier et al 2023). Meanwhile, SH may inspire career intents to shift from city to rural areas (Padley et al 2022).…”

Effects of chronic workplace harassment on mental health and alcohol misuse: a long-term follow-up

“…This substantial body of research shows that both SH and GH are associated with decrements to mental health including increased depression, anxiety, and suicidal ideation [ 8 , 13 , 14 ]. Recent cross-sectional research continues to show associations between SH and greater symptoms of depression, anxiety, suicidality, or poor mental well-being in samples as varied as women soldiers in Belgium [ 15 ], men and women medical school faculty in the Midwestern US [ 16 ], men and women medical students in France [ 17 ] and Switzerland [ 18 ], and international humanitarian field workers [ 19 ]. Research on GH, or closely related constructs such as workplace bullying, is not as common as SH research.…”