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Updated: Dec 5, 2025

The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
Published on: July 4, 2013
A multi-institutional study of patient-derived gender-based discrimination experienced by resident physicians
Anna Alaska Pendleton1, Sophia K McKinley2, Virginia E Pendleton3
1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA, USA.
Background:
This study characterizes prevalence, frequency, and forms of patient-derived gender-based discrimination (GBD) experienced by resident physicians, as well as their experiences witnessing and reporting patient-derived GBD.
Methods:
A web-based survey was sent to residents from 12 programs at three academic institutions.
Results:
Response rate was 47.9% (309/645) with 55.0% of respondents identifying as women. Women were more likely than men to experience patient-derived GBD during residency (100% vs 68.8%, p < 0.001), including inappropriate physical contact, receiving less trust from patients, and being mistaken for a nurse (p < 0.001). While 85.9% of residents personally experienced and 95.0% of residents witnessed patient-derived GBD, only 3.4% of residents formally reported patient-derived GBD. Women were more likely to report negative personal and professional consequences of patient-derived GBD.
Conclusions:
Patient-derived GBD is pervasive and disproportionately affects women residents. Current reporting mechanisms are not adequately capturing nor addressing patient-derived GBD.
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