This site uses tracking information. Visit our privacy policy. Click to agree to this policy and not see this again.

Ophthalmology and Visual Sciences

Tools for Responding to Patient-Initiated Verbal Sexual Harassment

Tools for Responding to Patient-Initiated Verbal Sexual Harassment

Contributors: Lauren E. Hock, MD, Brittni Scruggs, MD, PhD, Thomas A. Oetting, MD, Michael D. Abràmoff, MD, PhD, Erin M. Shriver, MD

The University of Iowa
Department of Ophthalmology and Visual Sciences


Sexual harassment is defined by the U.S. Equal Employment Opportunity Commission as, "unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature," that, "explicitly or implicitly affects an individual's employment, unreasonably interferes with an individual's work performance, or creates an intimidating, hostile, or offensive work environment" (EEOC, A national survey of mostly female ophthalmologists and ophthalmology trainees showed that 59% had experienced sexual harassment during their careers, most commonly during training [1]. Of the ophthalmologists who reported experiencing sexual harassment, 45% had been harassed by patients [1]. Few had reported their most significant experience with sexual harassment to an authority [1].


  • Exposure to sexual harassment among medical trainees has been associated with increased rates of depression, anxiety, insomnia, and post-traumatic stress disorder [2].
  • Among women ophthalmologists who had experienced sexual harassment, 87% reported significant impacts on their professional lives, including interference with their ability to work [1].
  • Institutional sexual harassment training often focuses on harassment initiated by supervisors or workers, and guidelines on responding to sexual harassment initiated by patients and families are sparse [3].
  • Sexual harassment affects all members of a clinical team when it negatively impacts a physician's ability to provide excellent patient care.


The Toolkit for Responding to Patient-Initiated Verbal Sexual Harassment was created in 2019 as part of a training program for ophthalmology faculty and trainees. It is meant to supplement existing sexual harassment training curricula. Toolkit strategies are designed for responding to patient-initiated verbal sexual harassment, but may be applied to other forms of mistreatment, including harassment based on race, age, or sexual orientation. If one decides to respond to patient-initiated verbal sexual harassment, generally a non-confrontational, non-judgmental tone is preferred [4].

Click here to download toolkit


View MedEdPORTAL curriculum for full workshop materials


  1. Cabrera MT, Enyedi LB, Ding L, MacDonald SM. Sexual Harassment in Ophthalmology: A Survey Study. Ophthalmology 2019;126(1):172-174. DOI: 10.1016/j.ophtha.2018.09.016
  2. Fnais N, Soobiah C, Chen MH, Lillie E, Perrier L, Tashkhandi M, Straus SE, Mamdani M, Al-Omran M, Tricco AC. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med 2014;89(5):817-827. DOI: 10.1097/ACM.0000000000000200
  3. Warsame RM, Hayes SN. Mayo Clinic's 5-Step Policy for Responding to Bias Incidents. AMA J Ethics 2019;21(6):E521-529. DOI: 10.1001/amajethics.2019.521
  4. Goodman DJ. Responding to biased or offensive comments. Promoting Diversity and Social Justice: Educating People from Privileged Groups. New York: Routledge; 2011.

Suggested Citation Format

Hock LE, Scruggs BA, Oetting TA, Abramoff MD, Shriver EM. Tools for Responding to Patient-Initiated Verbal Sexual Harassment. Posted August 20, 2019; Available from

Fast Find

Jump To Section: