‘Silenced and Unsafe’: Sexism and Assault in Med Schools – Medscape

Report on Sexism and Sexual Violence in UK Medical Education and its Implications for Sustainable Development Goals

Executive Summary

A recent survey conducted by the British Medical Association (BMA) reveals a pervasive culture of sexism and sexual violence within UK medical schools and clinical placements. These findings represent a significant challenge to the achievement of several key Sustainable Development Goals (SDGs), including SDG 5 (Gender Equality), SDG 3 (Good Health and Well-being), SDG 8 (Decent Work and Economic Growth), and SDG 16 (Peace, Justice and Strong Institutions). The report details a systemic failure to protect students, handle complaints effectively, and foster a safe learning environment, thereby undermining the principles of equality, justice, and well-being essential for a sustainable future workforce.

Key Findings: A Violation of Gender Equality and Well-being

Prevalence of Harassment and Assault

The UK-wide survey of nearly 1000 medical students highlights a crisis that directly contravenes SDG 5 (Gender Equality) by demonstrating disproportionate harm against female students and SDG 3 (Good Health and Well-being) by creating an unsafe and traumatic educational environment. Key statistics include:

• 41% of female respondents and 19% of male respondents experienced sexual harassment or sexual assault.
• Reported incidents included 37 cases of rape or assault by penetration.
• An additional 85 cases of sexual assault were reported.
• 43 instances of drink spiking were documented.

Institutional Failures: An Obstacle to SDG 16 (Peace, Justice and Strong Institutions)

Erosion of Trust in Reporting Mechanisms

The survey indicates a profound lack of faith in the ability of educational and healthcare institutions to provide justice and protection, a core target of SDG 16. This failure of institutional accountability is evidenced by:

• Three in four respondents who reported incidents were not satisfied with the institutional response.
• Two in three students did not report incidents at all, primarily due to a belief that no action would be taken.
• 60% of all respondents stated they did not trust their medical school to handle future incidents adequately.

Case Study: Ostracisation and Lack of Protection

Individual testimonies underscore the institutional failings. One female student reported being discouraged from escalating a harassment complaint to protect the university’s reputation. After formally reporting the incident, she felt “punished and ostracised,” with the perpetrator remaining in her classes despite promises of safeguards. This experience highlights a failure to build effective, accountable, and inclusive institutions at all levels.

Unsafe Clinical Placements and the Challenge to SDG 8 (Decent Work)

Vulnerability in the Workplace

Clinical placements, which function as students’ workplaces, are failing to meet the standards of safe and secure working environments as outlined in SDG 8. Students are exposed to harm without the necessary protections afforded to employees.

• Nearly seven in ten (69%) female students reported experiencing sexism during their clinical placements.
• One student described the reporting process for an assault by a senior doctor as “retraumatising and destructive,” indicating that university processes are ill-equipped to manage incidents occurring in NHS settings.

Systemic Gender Bias and its Impact on SDG 5 (Gender Equality)

Influence on Career Progression

The findings show that gender bias continues to shape career paths, limiting opportunities and reinforcing stereotypes, which directly undermines the goal of achieving gender equality and empowering all women and girls (SDG 5). The survey found that:

1. 43% of students reported that gendered advice had influenced their career decisions.
2. One female student was actively discouraged from pursuing a surgical career and advised to consider general practice for being “more compatible with having children.”

Dr. Emma Runswick, BMA deputy chair of council, noted that this culture creates impunity for perpetrators and normalises sexist behaviours, posing a long-term threat to equality within the NHS.

Institutional Responses and the Path Forward

Commitments to Strengthening Safeguards

In response to the report, key stakeholders have acknowledged the findings and pledged action. The Medical Schools Council expressed deep concern and committed to “actively strengthening” its reporting and safeguarding systems. NHS Employers described the findings as “bleak and worrying” and promised to work with universities to better protect students. These commitments are a crucial first step toward aligning institutional practices with the principles of the Sustainable Development Goals, ensuring a safe, just, and equitable environment for the next generation of doctors, which is fundamental to achieving SDG 3 (Good Health and Well-being) for the entire population.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

   The article on sexism and sexual violence in UK medical schools connects to several Sustainable Development Goals (SDGs) by highlighting failures in ensuring safety, equality, and well-being within educational and professional training environments.

   • SDG 3: Good Health and Well-being

     The article discusses traumatic events such as sexual assault, harassment, and rape, which have severe negative impacts on the mental and emotional well-being of medical students. The “retraumatising and destructive” reporting process further exacerbates this harm, directly conflicting with the goal of promoting well-being.

   • SDG 4: Quality Education

     The issues occur within an educational setting (medical schools and clinical placements). The article reveals that these are not safe, inclusive, or effective learning environments for many students, particularly women. The pervasive culture of sexism and the failure of institutions to protect students undermine the quality of education.

   • SDG 5: Gender Equality

     This is the central SDG addressed. The article explicitly details gender-based discrimination and violence. It provides statistics on the disproportionate number of female students experiencing sexual harassment, assault, and sexism. Furthermore, it highlights how gendered advice influences career choices, creating barriers to equal opportunities for women in medicine.

   • SDG 8: Decent Work and Economic Growth

     Clinical placements are a form of work and professional training. The article shows that these environments are unsafe for many students, who lack the protections afforded to regular NHS staff. The gender-biased career advice also relates to this goal by limiting women’s access to certain specializations, thus undermining the principle of equal opportunity in the workplace.

   • SDG 16: Peace, Justice and Strong Institutions

     A key theme is the failure of institutions (universities and the NHS) to provide justice and protection. The article describes a lack of trust, ineffective and non-transparent reporting mechanisms, and a culture of impunity for perpetrators. Students feel their cases are “futile” and are “punished and ostracised for speaking up,” indicating a profound weakness in institutional accountability and access to justice.

2. What specific targets under those SDGs can be identified based on the article’s content?

   The article’s content allows for the identification of several specific SDG targets that are not being met.

   • Under SDG 3: Good Health and Well-being

     • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article’s focus on the “retraumatising and destructive” experiences of students directly relates to the need to promote mental health and well-being.

   • Under SDG 4: Quality Education

     • Target 4.A: Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all. The survey findings show that medical schools and clinical placement sites are failing to provide a safe and non-violent environment, particularly for female students.

   • Under SDG 5: Gender Equality

     • Target 5.1: End all forms of discrimination against all women and girls everywhere. The report of widespread sexism during placements (69% of female students) and gendered career advice directly points to ongoing discrimination.
     • Target 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation. The survey data on rape, sexual assault, and harassment are direct evidence of the prevalence of violence against women in these institutions.

   • Under SDG 8: Decent Work and Economic Growth

     • Target 8.8: Protect labour rights and promote safe and secure working environments for all workers… The article highlights that students on clinical placement work in NHS hospitals “without the protections afforded to NHS staff,” indicating a failure to ensure a safe working environment.

   • Under SDG 16: Peace, Justice and Strong Institutions

     • Target 16.1: Significantly reduce all forms of violence and related death rates everywhere. The incidents of sexual violence, assault, and rape detailed in the article are forms of violence that this target aims to reduce.
     • Target 16.6: Develop effective, accountable and transparent institutions at all levels. The article is a powerful critique of institutional failure. The fact that “three in four respondents who reported incidents said they were not satisfied” and “60% of respondents said they did not trust their medical school” points to a lack of effective and accountable institutions.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

   Yes, the article provides several quantitative and qualitative data points from the BMA survey that can serve as direct indicators for measuring progress.

   • Indicators for SDG 5 (Gender Equality)

     • Proportion of women experiencing sexual violence: The article states, “41% of female and 19% of male respondents had experienced sexual harassment or sexual assault at university.” This is a direct indicator for Target 5.2.
     • Number of reported incidents of specific forms of violence: The article specifies “37 incidents of rape or assault by penetration, 85 cases of sexual assault, and 43 of drink spiking.” These numbers can be tracked over time.
     • Proportion of women experiencing sexism: The finding that “Nearly 7 in 10 female students (69%) reported sexism during placements” is a clear indicator for Target 5.1.
     • Proportion of students whose career decisions were influenced by gendered advice: The statistic that “43% of students said gendered advice had influenced their career decisions” measures a form of discrimination under Target 5.1.

   • Indicators for SDG 16 (Peace, Justice and Strong Institutions)

     • Satisfaction rate with institutional response: The fact that “Three in four respondents who reported incidents said they were not satisfied with how they were handled” serves as an indicator of institutional effectiveness (Target 16.6). Progress would be shown by an increase in this satisfaction rate.
     • Rate of non-reporting due to lack of trust: The finding that “Two in three said they did not report at all because they believed nothing would be done” is a powerful indicator of the lack of trust in justice systems (Target 16.6).
     • Level of trust in institutions: The statistic that “60% of respondents said they did not trust their medical school to handle future incidents adequately” directly measures trust in institutions, which is crucial for Target 16.6.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article. In this table, list the Sustainable Development Goals (SDGs), their corresponding targets, and the specific indicators identified in the article.

   SDGs	Targets	Indicators
   SDG 3: Good Health and Well-being	3.4: Promote mental health and well-being.	Qualitative mention of the reporting process being “retraumatising and destructive.”
   SDG 4: Quality Education	4.A: Provide safe, non-violent, inclusive and effective learning environments for all.	The overall findings of the survey demonstrating that the learning environment is unsafe and violent for a significant portion of students.
   SDG 5: Gender Equality	5.1: End all forms of discrimination against all women and girls everywhere.	69% of female students reported sexism during placements. 43% of students said gendered advice had influenced their career decisions.
   	5.2: Eliminate all forms of violence against all women and girls.	41% of female respondents experienced sexual harassment or sexual assault. Reported incidents included 37 cases of rape/assault by penetration and 85 cases of sexual assault.
   SDG 8: Decent Work and Economic Growth	8.8: Protect labour rights and promote safe and secure working environments for all workers.	Qualitative statement that students work in NHS hospitals “without the protections afforded to NHS staff.”
   SDG 16: Peace, Justice and Strong Institutions	16.1: Significantly reduce all forms of violence.	The statistics on rape, sexual assault, and harassment serve as direct measures of violence.
   	16.6: Develop effective, accountable and transparent institutions at all levels.	75% (3 in 4) of those who reported were not satisfied with the handling. 66% (2 in 3) did not report because they believed nothing would be done. 60% did not trust their medical school to handle future incidents adequately.

Source: medscape.com