Reporting Mistreatment or Harassment of Medical Students Policy

It is the policy of the University of Arizona College of Medicine – Phoenix (COM – P) to be committed to a safe and supportive learning environment. Mistreatment of medical students is unacceptable and is not tolerated.   

This policy is in addition to the University of Arizona Nondiscrimination and Anti-harassment Policy which prohibits discrimination, including harassment and retaliation, based on a protected classification including race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity or genetic information. Any violation of protected behavior is referred to the Office of Institutional Equity. 

Definition of Mistreatment

The Association of American Medical Colleges (AAMC) Graduation Questionnaire (GQ) defines mistreatment as: “Mistreatment either intentional or unintentional occurs when behavior shows disrespect for the dignity of others and unreasonably interferes with the learning process. Examples of mistreatment include sexual harassment; discrimination or harassment based on race, religion, ethnicity, gender or sexual orientation; humiliation; psychological or physical punishment; and the use of grading and other forms of assessment in a punitive manner.”

Specific examples of mistreatment include but are not limited to:

1. Verbal Mistreatment
   1. Yelling or shouting.
   2. Use of profanity.
   3. Humiliation, degradation, ridicule or put-downs.
   4. Non-constructive/non-corrective criticism.
   5. Malicious gossip.
   6. Threatening to hit or harm.
2. Ethnic Mistreatment
   1. Racial, ethnic, or sexual orientation discrimination, slurs, jokes, remarks.
   2. Stereotyped.
   3. Neglected/ignored because of ethnicity.
3. Physical Mistreatment
   1. Physically mistreated causing pain or potential injury.
   2. Pushed/slapped hand.
   3. Assault with a weapon (needles or surgical instruments also apply).
4. Power Mistreatment
   1. Being assigned work duties for the purpose of punishment rather than education.
   2. Creation of a hostile environment.
   3. Required to perform personal services (i.e., babysitting, shopping). Unjustified exclusion from formal or informal learning settings.
   4. Coercion.
   5. Threatened/intimidated with poor evaluation or grade consequences.
5. Sexual Harassment
   1. Being stared or leered at.
   2. Unwelcome sexual comments, jokes, innuendoes or taunting remarks.
   3. Display of pornographic, sexually offensive or degrading pictures.
   4. Unwanted sexual advances, including unnecessary physical contact by touching.
   5. Nonconsensual sexual intimacy.
   6. Unwanted social invitations (quid pro quo).
   7. Ignored because of gender.

Distinction Between Harassment and Embarrassment

There is a distinction between embarrassment, which is NOT mistreatment, and harassment, which is mistreatment. 

Embarrassment: The state of feeling foolish in front of others. 

• Example: An attending tells a student to prepare for an upcoming surgery by reviewing the relevant anatomy. The student fails to do so and is embarrassed when the attending asks an anatomical question during the surgery that the student does not know the answer to. 

Harassment: When an unpleasant or hostile situation is purposefully created. 

• Example: An attending physician purposely asks a question that a student is unlikely to know the answer to and then publicly calls the student “stupid.”

Process

1. Reporting concerns of possible mistreatment
   1. Medical students who are the subject of mistreatment or who have witnessed mistreatment of their fellow student are encouraged to make a confidential report to the Learning Environment Office (LEO) by submitting a Learning Environment form.   
   2. In preparation for filing a report, medical students may discuss concerns with a COM – P faculty/staff member who is in a position to understand the context. 
   3. In order to ensure student confidentiality, student information will only be visible to the LEO Liaison and LEO Consultant.  These individuals, who have no role in student assessment, will determine the best way to share the student report while upholding confidentiality based on student preference. 
   4. Retaliation against medical students who report is taken seriously, investigated, and not tolerated. Documented retaliation will result in professional consequences for those who retaliate.
   5. The following positions should be considered as primary resources:
      1. Learning Environment Office.
      2. Course* directors.
      3. Dean student affairs/or designee.
      4. Curricular dean(s).
      5. Vice dean, undergraduate medical education/or designee.
      6. Director, student development.
      7. Students on away rotations should report to the course* director at the site or to the above COM – P resources.
      8. Career and professional advisors.
2. Any report that involves unlawful discrimination or harassment covered under the University of Arizona Non-Discrimination and Anti-Harassment Policy will be referred to the Office of Institutional Equity for investigation and follow up.
3. Aggregated and de-identified data on reports of student mistreatment of medical students will be shared with the Curriculum Committee and its subcommittees semi-annually for review and possible action. Trending three-year GQ mistreatment data will be shared with students on an annual basis.
   1. Patterns of mistreatment that may not be reportable/notable as a specific incident but constitute an overall pattern by an individual or curricular unit environment will be addressed. 
4. The focus of remediation is to improve behavior and the teaching environment.  Actions taken in response to mistreatment may include feedback and education, mentoring, removal from student contact and disciplinary action, as appropriate.  Faculty development and one-on-one mentoring will be available to those who need to improve their behavior. 
5. Any report that suggests mistreatment received through any reporting mechanism or by individuals listed in 1.e. above will be referred to the Learning Environment Office. Any report that suggests unlawful discrimination or harassment under the University of Arizona’s Nondiscrimination and Anti-harassment Policy will be referred to the Office of Institutional Equity. Students may also directly report suspected discrimination or harassment to the Office of Institutional Equity.

Course* = Any component of the curriculum where a grade is earned.