Despite protections mandated in educational environments, unwanted sexual behaviors have been reported in medical training.1-4 Policies to combat such behaviors need to be based on better understanding of the perpetrators. We characterized faculty accused of sexual misconduct resulting in institutional or legal actions that proved or supported guilt at US higher education institutions in the biomedical and health sciences.
Given the nonpublic nature of most Title IX investigations, we performed internet searches after consultation with biomedical informatics experts to identify faculty accused of academic sexual misconduct. We searched sexual misconduct, sexual harassment, rape, sexual discrimination, and sexual assault followed by AND (instructor OR professor OR dean) AND (college OR medical school OR university OR Title IX) AND (medicine OR physician OR health science OR health services OR nurse OR dentist OR psychologist OR pharmacist OR researcher) in Google and FindLaw, a publicly accessible database of federal and state court decisions. The top 500–ranked search results excluding sponsored content were reviewed between November 2018 and April 2019.
To identify less prominent events, Google searches were repeated with the inclusion of individual states and the District of Columbia. Additional cases were identified through the Academic Sexual Misconduct Database, a continuously updated data set of academic sexual misconduct abstracted from publicly available documents and media reports.5 Both authors independently performed Google, Google News, and FindLaw searches of the accused faculty’s name to abstract characteristics and targets, institutional actions, and outcomes between April 2019 and July 2019, with an update in January 2020. Discrepancies were resolved by discussion between the authors.
The search results included public social profiles, institution websites, news reports, journal websites, and clinician board websites. The authors categorized the misconduct into assault (unwanted or nonconsensual sexual contact), harassment (sexual discrimination including oral, written, or physical behavior), consensual relationships, and exploitation (taking nonconsensual or abusive sexual advantage of other persons including voyeurism or distributing sexual information). Searches were not restricted to any time period. The study was exempt from institutional review board review under federal regulation because the data were publicly available.
We identified 125 faculty accused of sexual misconduct between 1982 and 2019 and affecting at least 1668 targets. Faculty were from a variety of disciplines and institution types, with 33.6% located at a US News & World Report top 50–ranked college or university. Of accused faculty, 97.6% were male and 91.5% targeted only females (Table); 72% of perpetrators targeted subordinates and 19.2% targeted clinical trainees. Half (51.2%) of perpetrators were full professors and 16.8% were department chairs, directors, or deans.
Sexual assault was committed by 29.6% and sexual harassment by 56%. Recurring inappropriate behaviors were exhibited by 87.2% of perpetrators, spanning years (median, 2 years; interquartile range, 1-7.5 years) and involving multiple targets (median, 2 targets; interquartile range, 1-4 targets). Of accused faculty, 49.2% resigned or retired, 20.8% were terminated, and 8.8% were sanctioned by funding sources or boards governing clinical practice. We identified 50 accused faculty who remained in academia, of whom 40% held positions at a different teaching institution. Of the 50 faculty who remained in academia, 6 had been terminated by the first institution, 15 had resigned or retired, and the remaining had faced sanctions or were disciplined.
Of biomedical and health sciences faculty accused of sexual misconduct resulting in institutional or legal action, a majority were full professors, chairs or directors, or deans. Sexual misconduct was rarely an isolated event. Accused faculty frequently resigned or remained in academics, and few were sanctioned by governing boards.
Limitations include that only data on accused faculty who received media attention or were involved in legal proceedings were captured. In addition, the duration of behaviors, the exact number of targets, and the outcome data could not be identified for all accused faculty. Thus, this study cannot determine the prevalence of faculty who commit sexual misconduct, and the characteristics may not be generalizable across institutions.
The lack of transparency in investigations suggests that misconduct behaviors may not have been wholly captured by the public documents. Efforts to eliminate nondisclosure agreements are needed to enhance transparency. Further work is needed on mechanisms to prevent sexual misconduct at teaching institutions.
Accepted for Publication: February 5, 2020.
Corresponding Author: David Hsiehchen, MD, University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390 (email@example.com).
Author Contributions: Dr Hsiehchen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: All authors.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: All authors.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: All authors.
Administrative, technical, or material support: Espinoza.
Conflict of Interest Disclosures: None reported.
National Academies of Sciences, Engineering, and Medicine. Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine. National Academies Press; 2018.