University of Malaya

More than half of all new doctors face some form of sexual harassment in their first year on the job, including nearly three-quarters of all new female doctors and a third of males, a new study finds. That's actually down somewhat from the percentage of new doctors who experienced the same five or six years before. More than half of all new doctors face some form of sexual harassment in their first year on the job, including nearly three-quarters of all new female doctors and a third of males, a new study finds. That's actually down somewhat from the percentage of new doctors who experienced the same five or six years before, according to the paper published in JAMA Health Forum by a team from the University of Michigan Medical School and Medical University of South Carolina. And today's new doctors are more likely than their predecessors to recognize that what they experienced qualifies as harassment, whether it was gender-biased comments or jokes, persistent unwanted romantic overtures, or pressure to engage in sexual activity for job-related reasons. But the new study and another paper published recently in JAMA Network Open suggest that medical schools and hospitals need to do more to educate about, and address, all forms of sexual harassment. Some institutions and specific medical specialties have more work to do than others, the research shows. That's especially true for profession-related sexual coercion, which increased across the six years studied, though it was much rarer than gender-based verbal or work environment harassment. In all, more than 5% of female first-year residents, also called interns, said in 2023 that they had been in a situation where they felt pressured to engage in a sexual activity in order to get favorable professional treatment. That was more than double the percentage who said so in 2017. The rate in men stayed the same, at less than 2%. "The overall decrease in sexual harassment incidence over recent years suggests a move in the right direction, however rates of sexual harassment experienced by physician trainees are still alarmingly high," said Elena Frank, Ph.D., lead author of the new study and an assistant research scientist at the Michigan Neuroscience Institute. The findings come from surveys of thousands of doctors who took part in the Intern Health Study, based at the institute. Each summer, the study enrolls thousands of recent medical school graduates who volunteer to take a variety of smartphone-based surveys and wear activity trackers for their entire intern year. Recognizing harassment The new JAMA Health Forum study includes data from nearly 4,000 doctors who finished intern year in 2017, 2018 or 2023. In addition to being asked a general question about whether they had experienced sexual harassment, they were also asked whether and how often they had had specific experiences that qualify as gender-based harassment, unwanted sexual attention and sexual coercion. That allowed the researchers to measure interns' recognition of what constitutes sexual harassment. To do so, they analyzed how many interns said they had had at least one of those specific experiences, and compared that with each person's answer on the general question of whether they'd experienced sexual harassment. In all, 55% of the interns in the 2023 group had experienced at least one form of sexual harassment. But only about 18% of that group recognized that they had experienced sexual harassment, and there was a big gap between women and men in recognition. Recognition of what constitutes sexual harassment has improved, the study shows; in 2017 less than 9% of those who had a sexual harassment experience recognized it as such. Recognition improved fivefold in surgical specialties. "The persistent gap between the experience and recognition of sexual harassment identified in our study illustrates the importance of looking beyond policy compliance, to challenge the deeply entrenched cultural norms that have enabled sexual and gender-based harassment to continue largely unquestioned in medicine for so long," said Frank, who directs the Intern Health Study team. The society-wide #MeToo movement for sexual harassment awareness and prevention has likely made a difference too. Variation in experiences The team explored differences between types and locations of medical training in their JAMA Network Open paper, which is based on 2,000 interns who finished intern year at 28 institutions in 2017. Interns training in surgery and emergency medicine were 20% more likely than those training in pediatrics or neurology to have experienced sexual harassment in 2017. And interns at some hospitals were 20% more likely to have experienced sexual harassment than those at hospitals with the lowest number of interns reporting any sexual harassment. Elizabeth Viglianti, M.D., M.P.H., M.Sc., lead author of the JAMA Network Open study and an assistant professor of internal medicine at U-M, notes that the variation between specialties and institutions seen in the study she led suggests that residency programs and hospitals play a key role in combating harassment. She notes that surgical training programs, which include general surgery and specialties that include surgical training such as gynecology, urology, otolaryngology, neurosurgery, plastic surgery and orthopedic surgery, have the most work to do. "Until administrators, faculty, and trainees truly understand that sexual harassment is not and should not be an expected or accepted part of the training experience, an equitable and safe learning environment for physicians cannot be achieved," Frank said. In addition to Frank and Viglianti, the authors of the two papers include Intern Health Study co-investigator Constance Guille, M.D., of the Medical University of South Carolina; Intern Health Study principal investigator Srijan Sen, M.D., Ph.D., who is also the director of the Eisenberg Family Depression Center and a professor of psychiatry and neuroscience at U-M; other U-M faculty Amy Bohnert, Ph.D., M.H.S., Andrea Oliverio, M.D., M.Sc., and Lisa Meeks, Ph.D. as well as Intern Health Study team members Zhuo Joan Zhao, M.S., Yu Fang, M.S.E., Jennifer Cleary, a doctoral student in psychology at U-M, and Karina Pereira-Lima, a Ph.D. student at the University of Sao Paolo. The Intern Health Study is funded by the National Institute of Mental Health (MH101459). Additional NIH funding was also used for the two studies.

Participation in recreational activities -- including golfing, gardening or yard work, woodworking and hunting -- may be associated with an increase in a person's risk for developing ALS. Researchers found that golf was associated with three times greater risk for developing ALS among men. Participation in gardening or yard work, as well as woodworking and hunting, was also linked with a heightened risk for men. Participation in recreational activities -- including golfing, gardening or yard work, woodworking and hunting -- may be associated with an increase in a person's risk for developing amyotrophic lateral sclerosis, or ALS, a Michigan Medicine study finds. While many activities were associated with increased ALS risk, several were sex specific. The results are published in the Journal of the Neurological Sciences. "We know that occupational risk factors, like working in manufacturing and trade industries, are linked to an increased risk for ALS, and this adds to a growing literature that recreational activities may also represent important and possibly modifiable risk factors for this disease," said first author Stephen Goutman, M.D., M.S., director of the Pranger ALS Clinic and associate director of the ALS Center of Excellence at University of Michigan. "Future studies should include these activities to pinpoint how they can be understood in the context of ALS prevention, diagnosis and treatment." Investigators surveyed 400 people living with ALS and nearly 300 without the condition to assess their hobbies and non-work related activities. They found that golf was associated with three times greater risk for developing ALS among men. Participation in gardening or yard work, as well as woodworking and hunting, was also linked with a heightened risk for men. When broken down by sex, no recreational activities had significant associations with ALS for females. None of the hobbies were linked to earlier onset of, or death from, ALS for either sex. "It is surprising that the risk factors we identified appear to be specific to males," Goutman said. "While these activities may also increase ALS risk in females, the number of females in our study was too small for us to come to that conclusion." The findings join the growing body of evidence suggesting that environmental exposures affect a person's risk for getting and dying from amyotrophic lateral sclerosis. Researchers call this lifetime accumulation of exposures the ALS exposome. Hobbies such as golfing and gardening or yardwork, Goutman says, may confer risk due to the use of pesticides. A past study connected occupations in golf and garden maintenance to increased ALS risk. Extensive studies of woodworking lead researchers to believe that formaldehyde exposure during the hobby could be attributed to higher risk. "Our goal is to understand what occupations and hobbies increase ALS risk because identifying these activities provides the first step towards ALS prevention," said senior author Eva Feldman, M.D., Ph.D., director of the ALS Center of Excellence at U-M and James W. Albers Distinguished University Professor at U-M. "For a disease like Alzheimer's, we know that a list of factors -- including smoking, obesity and high lipids -- can increase risk by 40%. Our goal is to establish a similar list for ALS to create a roadmap to decrease risk. With apologies to Robert Frost, it is currently the 'road not taken', and we want to change that." Prospective studies are underway to examine individuals who work in production, manufacturing and jobs that involve use of metals, and for persons with a family history of ALS. Both Goutman and Feldman say it is too early for clinicians to advise that patients stop doing any of these activities.

A protein engineering method using simple, cost-effective experiments and machine learning models can predict which proteins will be effective for a given purpose, according to a new study. A protein engineering method using simple, cost-effective experiments and machine learning models can predict which proteins will be effective for a given purpose, according to a new study by University of Michigan researchers. The method has far-reaching potential to assemble proteins and peptides for applications from industry tools to therapeutics. For instance, this technique can help speed up the development of stabilized peptides for treating diseases in ways that current medicines can't, including improving how exclusively antibodies bind to their targets in immunotherapy. "The rules that govern how proteins work, from sequence to structure to function, are so complicated. Contributing to the interpretability of protein engineering efforts is particularly exciting," said Marshall Case, a doctoral graduate of chemical engineering at U-M and first author of the study. Currently, most protein engineering experiments use complex, labor-intensive methods and expensive instruments to attain very precise data. The long process limits how much data can be acquired, and the complicated methods are challenging to learn and execute -- a trade-off for precision. "Our method has shown that for many applications, you can avoid these complicated methods," said Case, now a computational biologist at Manifold Biotechnologies. The updated method starts by sorting cells into two groups, known as binary sorting, based on whether they express a desired trait -- like binding to fluorescent molecules -- or not. Then, the cells are sequenced to get the underlying DNA codes for the proteins of interest. Machine learning algorithms then reduce the noise in the sequencing data to identify the best possible protein. "Rather than selecting the 'best book' from the library, it's like reading many books, then piecing together different pages from different stories to come up with the best book possible, even if it wasn't in your original library," said Greg Thurber, U-M associate professor of chemical engineering and corresponding author on the paper. "I was surprised to see the robustness of this technique using simple, binary sorting data." Further enhancing its accessibility, the method uses linear machine learning models, which are easier to interpret compared to models with dozens of parameters. "Because we can learn physical rules about how the proteins are actually working, we can use linear equations to model nonlinear protein behavior and make better drugs that way," Case said. The research was conducted at the Advanced Genomics Core, Center for Structural Biology, Biological Mass Spectrometry Facility and Proteomics & Peptide Synthesis Core.