7.16 Discrimination, Harassment, and Student Mistreatment
Harvard Medical School (HMS) takes issues of mistreatment seriously and aspires to a culture of zero tolerance for instances of abuse, mistreatment, and disrespect. HMS is committed to maintaining an environment free from discrimination, sexual harassment, unprofessional relationships, and abuses of authority. It is the strong and consistent policy of Harvard Medical School to treat all members of our community with respect, to provide an environment conducive to learning and working, and to ensure equal access to rights, privileges and opportunities without regard to race, color, sex, sexual orientation, gender identity, religion, age, national or ethnic origin, political beliefs, veteran status, disability, or any other legally protected category. Discrimination or harassment on the basis of these characteristics is inconsistent with Harvard’s principles and policies. Harvard expects that all those who interact with members of our community will comply with all applicable anti-discrimination laws.
Policies on Discrimination and Harassment
See also the HMS Ombuds website.
Sexual and Gender-Based Harassment
HMS has adopted the University-wide Sexual and Gender-Based Harassment Policy (“University Policy”) and the University’s Procedures for Handling Complaints Involving Students Pursuant to the Sexual and Gender-Based Harassment Policy (“University Procedures”). To the extent any existing HMS policies or procedures interfere with compliance with the University Policy and University Procedures, application of such HMS policies and procedures shall be suspended. The University Policy states as follows:
Harvard University is committed to maintaining a safe and healthy educational and work environment in which no member of the University community is, on the basis of sex, sexual orientation, or gender identity, excluded from participation in, denied the benefits of, or subjected to discrimination in any University program or activity. Gender-based and sexual harassment, including sexual violence, are forms of sex discrimination in that they deny or limit an individual’s ability to participate in or benefit from University programs or activities.
This Policy is designed to ensure a safe and non-discriminatory educational and work environment and to meet legal requirements, including: Title IX of the Education Amendments of 1972, which prohibits discrimination on the basis of sex in the University’s programs or activities; relevant sections of the Violence Against Women Reauthorization Act; Title VII of the Civil Rights Act of 1964, which prohibits discrimination on the basis of sex in employment; and Massachusetts laws that prohibit discrimination on the basis of sex, sexual orientation, and gender identity. It does not preclude application or enforcement of other University or School policies.
It is the policy of the University to provide educational, preventative and training programs regarding sexual or gender-based harassment; to encourage reporting of incidents; to prevent incidents of sexual and gender-based harassment from denying or limiting an individual’s ability to participate in or benefit from the University’s programs; to make available timely services for those who have been affected by discrimination; and to provide prompt and equitable methods of investigation and resolution to stop discrimination, remedy any harm, and prevent its recurrence. Violations of this Policy may result in the imposition of sanctions up to, and including, termination, dismissal, or expulsion, as determined by the appropriate officials at the School or unit.
Retaliation against an individual for raising an allegation of sexual or gender-based harassment, for cooperating in an investigation of such a complaint, or for opposing discriminatory practices is prohibited. Submitting a complaint that is not in good faith or providing false or misleading information in any investigation of complaints is also prohibited.
Nothing in this Policy shall be construed to abridge academic freedom and inquiry, principles of free speech, or the University’s educational mission.
Sexual harassment is unwelcome conduct of a sexual nature, including unwelcome sexual advances, requests for sexual favors, and other verbal, nonverbal, graphic, or physical conduct of a sexual nature, when: (1) submission to or rejection of such conduct is made either explicitly or implicitly a condition of an individual’s employment or academic standing or is used as the basis for employment decisions or for academic evaluation, grades, or advancement (quid pro quo); or (2) such conduct is sufficiently severe, persistent, or pervasive that it interferes with or limits a person’s ability to participate in or benefit from the University’s education or work programs or activities (hostile environment).
Quid pro quo sexual harassment can occur whether a person resists and suffers the threatened harm, or the person submits and avoids the threatened harm. Both situations could constitute discrimination on the basis of sex.
A hostile environment can be created by persistent or pervasive conduct or by a single severe episode. The more severe the conduct, the less need there is to show a repetitive series of incidents to prove a hostile environment. Sexual violence, including rape, sexual assault, and domestic and dating violence, is a form of sexual harassment. In addition, the following conduct may violate this Policy:
- Observing, photographing, videotaping, or making other visual or auditory records of sexual activity or nudity, where there is a reasonable expectation of privacy, without the knowledge and consent of all parties
- Sharing visual or auditory records of sexual activity or nudity without the knowledge and consent of all recorded parties and recipient(s)
- Sexual advances, whether or not they involve physical touching
- Commenting about or inappropriately touching an individual's body
- Requests for sexual favors in exchange for actual or promised job benefits, such as favorable reviews, salary increases, promotions, increased benefits, or continued employment
- Lewd or sexually suggestive comments, jokes, innuendoes, or gestures
Other verbal, nonverbal, graphic, or physical conduct may create a hostile environment if the conduct is sufficiently persistent, pervasive, or severe so as to deny a person equal access to the University’s programs or activities. Whether the conduct creates a hostile environment may depend on a variety of factors, including: the degree to which the conduct affected one or more person’s education or employment; the type, frequency, and duration of the conduct; the relationship between the parties; the number of people involved; and the context in which the conduct occurred.
Conduct is unwelcome if a person (1) did not request or invite it and (2) regarded the unrequested or uninvited conduct as undesirable or offensive. That a person welcomes some sexual contact does not necessarily mean that person welcomes other sexual contact. Similarly, that a person willingly participates in conduct on one occasion does not necessarily mean that the same conduct is welcome on a subsequent occasion.
Whether conduct is unwelcome is determined based on the totality of the circumstances, including various objective and subjective factors. The following types of information may be helpful in making that determination: statements by any witnesses to the alleged incident; information about the relative credibility of the parties and witnesses; the detail and consistency of each person’s account; the absence of corroborating information where it should logically exist; information that the Respondent has been found to have harassed others; information that the Complainant has been found to have made false allegations against others; information about the Complainant’s reaction or behavior after the alleged incident; and information about any actions the parties took immediately following the incident, including reporting the matter to others.
In addition, when a person is so impaired or incapacitated as to be incapable of requesting or inviting the conduct, conduct of a sexual nature is deemed unwelcome, provided that the Respondent knew or reasonably should have known of the person’s impairment or incapacity. The person may be impaired or incapacitated as a result of drugs or alcohol or for some other reason, such as sleep or unconsciousness. A Respondent’s impairment at the time of the incident as a result of drugs or alcohol does not, however, diminish the Respondent’s responsibility for sexual or gender-based harassment under this Policy.
Gender-based harassment is verbal, nonverbal, graphic, or physical aggression, intimidation, or hostile conduct based on sex, sex-stereotyping, sexual orientation or gender identity, but not involving conduct of a sexual nature, when such conduct is sufficiently severe, persistent, or pervasive that it interferes with or limits a person’s ability to participate in or benefit from the University’s education or work programs or activities. For example, persistent disparagement of a person based on a perceived lack of stereotypical masculinity or femininity or exclusion from an activity based on sexual orientation or gender identity also may violate this Policy.
This Policy applies to sexual or gender-based harassment that is committed by students, faculty, staff, Harvard appointees, or third parties, whenever the misconduct occurs:
1. On Harvard property; or
2. Off Harvard property, if:
a) the conduct was in connection with a University or University-recognized program or activity; or
b) the conduct may have the effect of creating a hostile environment for a member of the University community.
Monitoring and Confidentiality
A variety of resources are available at the University and in the area to assist those who have experienced gender-based or sexual harassment, including sexual violence.
Individuals considering making a disclosure to University resources should make sure they have informed expectations concerning privacy and confidentiality. The University is committed to providing all possible assistance in understanding these issues and helping individuals to make an informed decision.
It is important to understand that, while the University will treat information it has received with appropriate sensitivity, University personnel may nonetheless need to share certain information with those at the University responsible for stopping or preventing sexual or gender-based harassment. For example, University officers, other than those who are prohibited from reporting because of a legal confidentiality obligation or prohibition against reporting, must promptly notify the School or unit Title IX Coordinator about possible sexual or gender-based harassment, regardless of whether a complaint is filed. Such reporting is necessary for various reasons, including to ensure that persons possibly subjected to such conduct receive appropriate services and information; that the University can track incidents and identify patterns; and that, where appropriate, the University can take steps to protect the Harvard community. This reporting by University officers will not necessarily result in a complaint; rather, the School or unit Title IX Coordinator, in consultation with the Title IX Officer, will assess the information and determine what action, if any, will be taken. Information will be disclosed in this manner only to those at the University who, in the judgment of the Title IX Officer or School or unit Title IX Coordinator, have a need to know.
Should individuals desire to discuss an incident or other information only with persons who are subject to a legal confidentiality obligation or prohibition against reporting, they should ask University officers for information about such resources, which are available both at the University and elsewhere. University officers are available to discuss these other resources and to assist individuals in making an informed decision.
Violations of other Rules
The University encourages the reporting of all concerns regarding sexual or gender-based harassment. Sometimes individuals are hesitant to report instances of sexual or gender-based harassment because they fear they may be charged with other policy violations, such as underage alcohol consumption. Because the University has a paramount interest in protecting the well-being of its community and remedying sexual or gender-based harassment, other policy violations will be considered, if necessary, separately from allegations under this Policy.
Harvard Medical School defines racial harassment as actions on the part of an individual or group that demean or abuse another individual or group because of racial or ethnic background. Such actions may include, but are not restricted to, using racial epithets, making racially derogatory remarks, and using racial stereotypes.
Reporting Allegations of Mistreatment, Discrimination or Harassment
For allegations of sexual and gender-based harassment: HMS students wishing to report a violation of the University Policy should begin in all cases by contacting the Harvard University Office for Sexual and Gender-Based Dispute Resolution (“ODR”) or an HMS Title IX Coordinator. For all cases where the person alleged to have violated the University Policy is a student, ODR has been charged with implementing the University Procedures, which include processes for initial review, investigation, and determination of whether there was a violation of the University Policy. If the person alleged to have violated the University Policy is not a student, ODR will refer the case to the relevant Title IX Coordinators and other representatives of HMS, as appropriate. A description of the steps that will take place once a complaint is initiated can be found in the University Procedures. Additional information is also available from ODR.
For all other allegations: HMS has adopted two formal reporting mechanisms: 1) through course and clerkship evaluations; and 2) through direct communication to the Dean for Medical Education.
Course and Clerkship Evaluations
Students are encouraged to report instances of mistreatment that occur during a course or clerkship. Reporting these incidents helps the School and its affiliated hospitals sustain an environment of collegiality and mutual support. HMS Course and Clerkship Evaluation forms, which are anonymous, now include three additional questions regarding possible incidents of mistreatment.
In considering potential instances of mistreatment, students should keep in mind that clinical practice and clinical training involve a high level of accountability to the well being of patients, and expectations of clinicians and of students are high. Accordingly, part of clinical training may be uncomfortable—e.g., being “put on the spot” on rounds or in the operating room—but does not constitute mistreatment. With this fine distinction in mind (e.g., between appropriate accountability and inappropriate disrespect), students should respond to the questions on the course and clerkship evaluation forms using good judgment in reporting and describing all incidents, if applicable.
Direct Reporting of Troubling Incidents
Students who experience a troubling instance (or instances) of mistreatment personally or witness such behavior have the option, and are encouraged, to report such incidents to the immediate attention of the Dean for Medical Education, who will treat such reports with discretion. Reports of sexual and gender-based harassment should be made to the Harvard University Office for Sexual and Gender-Based Dispute Resolution (“ODR”) or an HMS Title IX Coordinator, as described above.
Procedures for Addressing Complaints of Mistreatment, Discrimination, or Harassment
For allegations of sexual and gender-based harassment: As set forth above, HMS has adopted the University’s Procedures for Handling Complaints Involving Students Pursuant to the Sexual and Gender-Based Harassment Policy (“University Procedures”), which can be found here. If the person alleged to have violated the University Policy is not a student, ODR will refer the case to the relevant Title IX Coordinators and other representatives of HMS, as appropriate.
Under the University Procedures, ODR is responsible for determining whether a violation of the University Policy by a student took place. HMS remains responsible for student discipline through the Promotion and Review Board. Whenever a formal complaint of sexual or gender-based harassment against an HMS student results in the issuance of a final report from the ODR, the Promotion and Review Board must accept as final and non-reviewable the report’s findings of fact and its conclusions as to whether a violation of the University Policy has occurred. The Promotion and Review Board’s disciplinary proceedings against that student based on conduct addressed by the report will proceed with the understanding that the final report carries the same validity as a determination reached by the Promotion and Review Board itself.
For all other allegations: The Program in Medical Education (PME) is committed to addressing allegations of student mistreatment in a manner that protects students from potential retaliation or reprisals. At the same time, implementation of the policy requires thoughtful and fair treatment of faculty, house officers, and others against whom allegations of student mistreatment may be brought. When a web-based allegation of mistreatment is received by the Dean for Medical Education, he will make a determination of whether the event warrants immediate action or should be aggregated with other such events (to limit potential identification of the complainant, which could lead to retaliation) before remediation is pursued. Similarly, when allegations of mistreatment appear on required student course/clerkship surveys, the Center for Evaluation will collate the reports and make a similar determination of whether immediate action or a delay in releasing the comments to faculty is warranted.
The PME will work with offices at the affiliated hospitals, e.g., the Center for Professionalism and Peer Support at the Brigham & Women’s Hospital, to address complaints of mistreatment. In addition, PME leadership will communicate with residency and fellowship directors for complaints against residents and fellows, with division chiefs and/or department chairs for complaints about faculty, and with hospital leaders for complaints about department chairs.
In cases where there is significant uncertainty and ambiguity, the Dean for Medical Education will appoint a joint faculty-student ad hoc committee to consider the complaint of mistreatment and will rely on the committee’s recommendation for reporting and remediation.
Cases of alleged harassment by medical students will be adjudicated by the Harvard Medical School Promotion and Review Board (Section 4).
A student may seek counsel in a matter involving mistreatment, discrimination, affirmative action, or harassment through an appropriate officer, such as the HMS Ombudsperson; the University Title IX Officer or an HMS Title IX Coordinator; a Society Advisory Dean/Director or Associate Director; a faculty advisor/mentor; a course, clerkship or PCE director; the coordinator of services for students with disabilities; the Dean for Students or other Harvard Medical School or hospital official.
- Academic Societies (Section 3.02)
- Office of Advising Resources (Section 3.03)
- Office of Student Affairs (Section 3.04)
- Office for Sexual and Gender-Based Dispute Resolution
- HMS Title IX Coordinators (Section 10.16)
- Office of Recruitment and Multicultural Affairs (Section 3.05)
- Coordinator of Disability Services (Section 10.03)
- Ombuds Offices
- HMS (Section 10.05; http://hms.harvard.edu/departments/ombuds-office)
- HU (http://www.universityombudsman.harvard.edu/)
- Hospitals: The affiliated hospitals and institutions may have their own policies pertaining to your concern. Discuss your issue with the HMS Ombudsperson and/or check with the appropriate office in the institution in which you are rotating.
You may also consult:
- PCE mentors/advisors
- PCE and/or Clerkship Directors