Physician respondents in sexual misconduct concerns in Canada: a comparative case analysis using publicly available information

Background: Much of the data about physician harassment and discrimination come from self-report surveys or qualitative data. We used publicly available sources to systematically identify physician-originating sex- and gender-based harassment and discrimination reported over a 5-year period. Methods: We performed systematic searches of Canadian news outlets (Canadian Newsstream), legal decisions (Canadian Legal Information Institute), and regulatory body notifications (websites of colleges of physicians and surgeons) to identify instances of harassment and discrimination involving a physician reported from Aug. 1, 2019, to July 31, 2024, in Canada. Data extraction was performed in duplicate. We performed comparative case analysis to generate insights related to physician-originating sex- and gender-based harassment and discrimination. Results: We found 1437 records that described 208 physician respondents involved in concerns of sex- or gender-based harassment or discrimination during the study period. Of the estimated 689 victims, 585 were women or girls (84.9%) and at least 40 were children (5.8%). Sexual-boundary violations or sexual misconduct was the most common category (n = 75, 36.1%) followed by sexual assault (n = 65, 31.3%). A police complaint occurred for 72 cases (34.6%), and 29 physicians were convicted (65.9% of trials). Comparative case analysis generated several important themes, including physicians not self-reporting criminal convictions, resulting in no practice restrictions; news media being an important mechanism for additional complainants to come forward; and a substantial proportion of physician respondents having had a previous complaint (29.8%). Interpretation: In our study, most victims of physician-originating sex- or gender-based harassment or discrimination in Canada were women or girls, and many physician respondents were not restricted in their practice. Gaps in remediation and monitoring of physicians with previous complaints are apparent; analysis of current regulatory practices would be more feasible if data reporting by Canadian regulatory bodies were more transparent.