Jun 3, 2019

Dr. Marina Stasenko discusses the results of a survey that her team conducted which identified sexism and bias in gynecologic practices.

Welcome to the ASCO Daily News Podcast. I'm Lauren Davis and joining me today is Dr. Marina Stasenko, a gynecologic oncology fellow at Memorial Sloan Kettering Cancer Center. She and her team conducted a survey of oncologists in her subspecialty to learn more about their experiences with being sexually harassed and mistreated in the workplace. Results of her study are being released during the ASCO annual meeting. Dr. Stasenko, welcome to the podcast.

Thank you so much for having me today.

today we're talking about sexual harassment in the workplace. Bullying, sexism, aggression, and rudeness are all common in the medical profession. One third of US women report experiencing unwanted sexual advances in their careers. What do you attribute that to?

I think medicine, for many years, has really been a boys club. There have been very few women in leadership. And sexual harassment, when it did happen, just really wasn't mentioned. Over the last several decades, the face of medicine really has changed quite a bit. But I think that this study shows sexual harassment and gender biases still remain quite a pervasive problem.

Was this the reason you decided to conduct a survey about this issue?

Yeah. So while sexual harassment is not a new phenomenon, I think the #MeToo and the Time's Up movements have really shined a spotlight on it in areas like film and [INAUDIBLE] and even the tech industry. Unfortunately, in medicine, this discussion has really remained largely limited to private conversations. There are a few notable exceptions. But a lot of the literature that's been published really revolves around personal anecdotes. Specifically there really hasn't been a formal look at the experience of gynecologic oncologists in terms of gender disparities.

So the purpose of our study was really to see what positions within our very woman focus of specialty were experiencing in regards to both gender bias disparities and discrimination. We really hope that our study adds to the growing conversation by providing a more structured look at the members of our subspecialty. I think that by identifying the problem, our study can act as a springboard for future changes.

Right now, about half of practicing GYN oncologists are women. And that number is just going to continue to grow. A large portion of practicing GYN oncologists are members of the Society of GYN Oncology. This is why we've targeted our survey to the members of the SGO.

We sent out an email inviting all members to fill out a short, 30-question survey. Of the roughly 1,500 members that we contacted, about 402 filled out the survey. And we actually do think that this is a good representation of our field. The responders were about 60% women and 40% men. And given the nature of the survey, we were actually very pleased with this response rate.

Absolutely. The survey illustrates a big problem for women in oncology. According to the survey, why do some women not report the conduct of their colleagues when they have been mistreated?
So in out study, 70% of women that responded endorsed having faced some form of sexual harassment, either during their training or while in practice. The most frequent forms of harassment were being subjected to either sexist remarks or sexual advances and receiving lower evaluations or academic positions based on gender.
While most of the responders said that they were aware of work policies to report this behavior, unfortunately, fewer than 20% actually reported it. The most common reason for not reporting was that the incident just didn't seem important enough. And about 40% of respondents said this.

Another third did not think anything would be done about the incident. And then, still another third were fearful of reprisal. Other less common [INAUDIBLE] thinking the issue would just resolve itself, not knowing how to report it, and then being concerned of how they would deal with a colleague once they did report the incident.

What about bias in the workplace? How is this affecting people's ability to do research and care for patients?

I think this is probably the crux of our study. I think there is overt ways that sexual harassment or gender biases affect women's growth. And then, there are the more covert ways. Women can be passed up for promotions or have significantly lower salaries. I think this is a conversation that's really widespread at this point.
But the covert consequences are really the ones that should be mentioned. And these can include female physicians being unwilling or unable to voice their opinion in larger crowds or their expertise is just not being taken as seriously as their male colleagues.
In our study, significantly more of women than men felt that gender affected their career advancement and played a role in setting their salary. But I do think it's interesting to mention that 90% of male responders felt that there was no gender pay gap in the field of GYN oncology.

What do you see for women in oncology going forward? I think the future is bright. I'm hopeful that with the growing number of women in oncology and, more importantly, in leadership positions and with just a general greater awareness of the effects of sexual harassment and gender bias in our field, we will really see a culture and policy shift over the coming decade.

Our final survey question was an interesting one. It was an open ended question. And we asked what changes the responders wanted to see implemented. Common themes you probably won't be surprised to hear included increasing female leadership, having open salary reporting, more transparency in hiring and promotion, more flexibility for parents, and that included both mothers and fathers, and then a general acknowledgment within our specialty that sexual harassment and gender biases do in fact exist.
I do want to end on a positive note. I think it's important to mention that actually quite a few of our responders felt that our field was doing fairly well in terms of gender disparities. Because as one responder put it, women are more than holding their own. Our general hope with conducting the survey was to fuel a conversation and to fuel action within both the local GYN oncology community as well as within our specialty at large.

What's our next step? Where do we go from here? I think we can take an example from emergency medicine female physicians. And there's an organization called Them in M. And this is a network that allows women in emergency medicine to engage in dialogue and explore a variety of issues regarding gender disparities. We would love to see a similar network for women in oncology, where women can really discuss these issues as they relate to work and gender and then find common strategies that can help them face challenges head on.

Yes. And hopefully, some women are able to attend the Women's Networking Center during the Annual Meeting.

Exactly. I think we have these key opportunities at our large annual meetings, the social network, places that we can virtually gather and physically gather to really talk about these issues as they affect us on a daily basis, as well as kind of our field as a whole and see where we can go from here. I think women in medicine, and especially women in oncology are incredibly bright, incredibly motivated, and really will change the field in an incredibly positive way.

Again, today my guest has been Dr. Marina Stasenko. Thank you for being on our podcast today.
Thank you so much for taking the time.

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