In the wake of criminal charges against the former dean of the Michigan State University College of Osteopathic Medicine (MSUCOM), the Commission on Osteopathic College Accreditation (COCA) recently reviewed all student complaints from the past five years to assess any potential problems or trends regarding sexual harassment allegations in osteopathic medical schools.
The review found no complaints of sexual misconduct against faculty at any COM, nor any complaints involving MSUCOM.
Yet the issue of sexual harassment in medical training has been documented for decades. A 1993 New England Journal of Medicine article detailed the experiences of more than 80 internal medicine residents. In the findings, 73 percent of female residents and 22 percent of male residents reported that they had been sexually harassed at least once during their training.
Little seems to have changed in the past 25 years. In March, JAMA Internal Medicine published “Persistence of Sexual Harassment and Gender Bias in Medicine Across Generations—Us Too,” which noted that only 20 percent of sexual harassment cases in medicine are reported.
Below, Brian Kim, JD, COCA secretary and AOA vice president of accreditation, outlines the channels available to students who wish to report sexual harassment.
How should students report sexual harassment?
Issues involving sexual harassment should generally be brought to the school’s leadership and its Title IX officer, who is responsible for investigating complaints.
Every accredited school is required to maintain records under the Clery Act, a federal law mandating that all postsecondary institutions participating in the Higher Education Act’s Title IV student financial assistance programs disclose campus crime and security information, including instances of sexual harassment and other sexually motivated incidents, Kim said. Crime statistics are submitted to the U.S. Department of Education.
In addition to any of the established complaint processes through a COM or through the COCA complaint process, students who allege that they were inappropriately touched or threatened may report the incident to law enforcement authorities for criminal investigation. Also, students may report such incidents to the U.S. Department of Education Office of Civil Rights, which maintains regional offices throughout the United States.
Private legal counsel can assist with other forms of harassment, such as name-calling or quid pro quo offers, in which persons of authority offer favorable treatment in exchange for sexual favors.
What about COCA?
Because COCA accredits colleges of osteopathic medicine and ensures each school continuously meets the accreditation standards, it is generally not the best authority to handle reports of sexual harassment, notes Kim. This is because COCA has no authority to directly impose discipline on individual faculty members. The COCA’s authority is to affect the accreditation status of a COM.
“COCA is not the best path for reporting sexual harassment because its role is to ensure accreditation standards are continuously met. Title IX is intended to address sexual harassment, but there may be circumstances in which the Title IX function isn’t effective or fully established, particularly in new COMs,” Kim explained. “In those cases, COCA may be able to provide some recourse for students.”
In order for COCA to validate a sexual harassment complaint, it must determine that an accreditation standard may have been violated. The most important element in making an effective COCA complaint is citing the accreditation standard violated by the alleged behavior, Kim noted.
In sexual harassment cases, violations are likely specific to standards involving ethics, professionalism and student services.
COCA complaint process
COCA rules require complainants identify themselves to the COCA, but the COCA does not disclose the identity of the complainant to the COM. Anonymity is protected throughout the process.
All submissions received by COCA are confidential and are handled solely by AOA staff. If, after an investigation, the COCA Executive Committee determines that further review is necessary, a COM may be subject to a site visit or other monitoring.
The COCA Executive Committee could also refer the matter to the entire COCA for future deliberation. In some cases, complaints could result in an adverse accreditation decision, where the factual underpinnings are directly related to an accreditation standard. Commissioners representing a school that is the subject of a complaint must recuse themselves from participating.
Fear of reprisals remains a barrier to reporting sexual harassment at the COM level, according to some educators.
“Students are always concerned that their information won’t be able to be kept confidential and that a complaint will have a negative impact on their clerkship rotation grades or on subsequent rotations at that same site, so I am certain that not all situations are reported,” said Karen Nichols, DO, AOA past president and dean of the Midwestern University Chicago College of Osteopathic Medicine.
“My recommendation to any student who’s been harassed is to go to a person in authority whom they trust and, if they don’t get satisfaction, know that there are other pathways to pursue. Students may not realize that there are options available,” Dr. Nichols added.