"My world is broken and it will never be the same". Sexual abuse of doctors, by doctors: professionalism, trauma and the potential for healing.

Problem

Internationally, 33% of medical trainees have experienced sexual harassment. (Fnais, Academic Medicine, 2014) Recent disclosures in Australia, particularly in surgery, suggest that a culture of bullying and harassment is common in Australian hospitals. My conversations with experts in sexual abuse, doctor’s health, professional regulation and medical training in Australia and overseas confirms that doctors are experiencing sexual trauma in our medical institutions. However, little is known about their lived experience.Without research and academic literature, there can be little clinical or academic conversation around the management of these doctors, and no organisational response to the culture that enables or tolerates this behaviour.

Approach

This qualitative study was designed to explore the way doctors construct narratives around their experience of sexual abuse, and to identify narrative typologies in these stories which suggest opportunities for therapeutic interventions.The research was conducted with the oversight of an expert reference group: appointed to ensure quality in ethically sensitive research processes, effective methodological design, appropriate dissemination and effective research translation. Given the traumatic nature of the events under discussion, it was important to choose a methodology that enabled the participants to choose the nature and manner of story-telling. The study used narrative inquiry involving in-depth interviews. Analysis included other texts, such as legal documents, media reports and policy frameworks.Seven doctors who had experienced sexual abuse from other doctors were interviewed. They were recruited through College newsletters, social media and articles in the medical press. All were registrars at the time of the abuse. Sexual abuse was defined using the World Health Organisation criteria as “any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances…using coercion.”

Findings

The study raised deep concerns about the silencing of abuse and the treatment of “victim whistleblowers” in the profession. This presentation focuses on the experiences of three participants who were assaulted by their supervisors while undertaking registrar training. All three won their cases in a civil or criminal court. Each obtained their College Fellowship, but their careers were profoundly and permanently affected. All experienced a sense of deep betrayal; by the perpetrator, the profession, the Colleges, their hospital HR systems and by bystander colleagues. None were able to access appropriate GP care.

Consequences

Sexual harassment is occurring in our profession, and rape culture is alive and well in our professional worlds. We need to understand and address toxic medical culture, but we also need to take responsibility for the care and recovery of our colleagues. Their trust in their own profession is broken. This study highlighted missed opportunities for GPs to provide validation, support and care for these doctors, outside of the institutions that have failed to protect them.