Session Summary: Strategies to Manage the Evolution of Title IX and What GME Leaders Should Know

In one of four Featured Plenaries at the 2025 ACGME Annual Educational Conference, ACGME Vice President, Diversity, Equity, and Inclusion Pilar Ortega, MD, MGM led a discussion with experts on the impact and practical application of Title IX in graduate medical education (GME). Panelists included Kimberly Templeton, MD, vice chair at the University of Kansas; Lauren Jones McKown, JD, associate vice chancellor at the University of Kansas; and Jenny Mladenvoic, MD, MBA, president/CEO at the Center for Women in Academic Medicine and Science. Despite progress, gender disparities and sexual harassment remain prevalent in the field. These behaviors, often dismissed as jokes or humor, can have long-term consequences.

Title IX in GME
While Title IX does not supersede clinical requirements, it ensures protection and promotes a trauma-informed approach to addressing grievances. Encouraging a culture of accountability, transparency, and proactive support measures is key to creating a learning environment where all can thrive.

“If you don’t have a safe culture where women and other underrepresented minorities feel they can report, then they won’t feel they can say something is wrong, and then we cannot fix it,” emphasized by Dr. Templeton.

Enacted in 1972 and enforced by the US Department of Education’s Office for Civil Rights, Title IX has played a significant role in shaping educational environments in this country for more than 50 years. In GME, faculty members, residents, and fellows often face burnout and isolation. Sexual harassment, including microaggressions and gender discrimination, is alarmingly common, with statistics showing that one in four women and one in 31 men experience it. These behaviors can have a significant effect on individuals’ career progression, morale, and patient care.

Microaggressions Are Typically a Pattern of Behavior
One incident isn’t likely to be the only issue, but rather a reflection of a longer history or culture around a behavior or attitude. Microaggressions—subtle, often repeated acts stemming from conscious or unconscious biases—reinforce gender disparities in medicine. Women frequently face biases related to pregnancy, childcare, and professional capabilities, and are often assigned more mundane tasks or are perceived as nurses rather than physicians. Although gender disparities in certain medical fields, like orthopaedics, are decreasing, women still experience less autonomy in procedures, despite handling the same number of cases. The effects of these biases are profound, leading women to feel on guard, work harder, and experience a lack of belonging, which contributes to burnout and can push them to leave the field altogether.

The issue with microaggressions, the panel said, is that it can be significantly harder to identify than more overt behaviors like sexual assault or sexual coercion.

Dr. Templeton explained that “with microaggressions… the behavior is based on how its received, not how it was intended,” adding that “the vast majority of women in medicine have been the victim of microaggressions at some point.” In fact, she said, some studies [show that] over 90 percent of women at some point have been subjected to at least one microaggression.”

Don’t Worry About Overreporting
Reporting issues can be challenging for those experiencing incidents of gender-based harassment or discrimination. Many fear retaliation, lack of support, and uncertainty about the process of investigation, and therefore hesitate to report. Title IX coordinators and institutional policies play a vital role in fostering a safe and inclusive learning environment. Title IX provides protection and a trauma-informed approach to addressing grievances. A culture of accountability, transparency, and proactive support measures is key to creating a learning environment where all can thrive. One way to create this culture is by providing resources to a dedicated role or office.

“A good Title IX Coordinator would serve their institution well by embracing trauma-informed practices,” said Ms. Jones McKown.

Panelists emphasized the importance of allowing Title IX coordinators to handle investigations. Independent inquiries or investigations can compromise the integrity and outcomes of the process. They also stressed that it is critical to receive as much information as possible to inform the investigation, and that hearing from multiple sources is helpful.

“We would always rather receive multiple reports about something, then not hear about it at all,” said Ms. Jones McKown.

Key Takeaways
The last portion of the session included an interactive case study review, in which audience members were presented with cases and asked to vote on whether the situation described in each case warranted reporting to the Title IX office. Discussion of the cases followed. Finally, the speakers closed with some key takeaways:

• Engage program coordinators.
  They serve as the frontline contact for learners, who may feel more comfortable approaching them first. Empower coordinators to escalate concerns and actively participate in the reporting process.
• Incorporate regular Title IX education.
  Integrating Title IX training into routine development meetings, such as orientations, fosters a proactive approach rather than a reactive one.
• Ensure transparency in reporting.
  Clearly outline reporting steps and provide multiple reporting channels to ensure accessibility. Regular education on these processes will help keep all parties informed.