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CHICAGO -- Members of the American Medical Association (AMA) House of Delegates adopted new policies aimed at protecting medical students and residents from sexual harassment, during the association's on Monday.

During the virtual meeting on Saturday, the Medical Student Section (MSS) introduced a calling for the AMA to work with "relevant stakeholders" to advocate for the Department of Education (DOE) to overhaul the 2020 Title IX rule on sexual harassment and assault within educational settings and substitute it with a more comprehensive rule that "preserves the safety and wellbeing of all people affected by sexual assault."

Meghna Peesapati, an alternate delegate from Indiana, speaking on behalf of the MSS, noted that 52% of medical students report harassment and that the Title IX regulations proposed in 2020 were "more strict and less protective" of victims of sexual harassment then previous iterations. The proposed rule makes it harder for victims to argue their case, subjects them to "extensive cross examination," and places the evidentiary burden on victims, she explained. Additionally, the rule does not require schools to investigate any incident that occurs outside of school grounds.

The AMA has yet to take a stance on the guidelines, which clash with the association's own policies on gender-based harassment and discrimination, Peesapati said.

She also stressed the urgency of quick action, as the Biden administration is making recommendations to reform the rule in May 2022.

Nicole Plenty, MD, a delegate for the Women Physicians Section, stressed her support for the resolution -- particularly, the need to address off-campus harassment given that many students and residents live off campus and rotate off site, and even out of state.

She noted that harassment by a colleague or a superior can interfere with students' education and may cause them to leave their programs. Some victims are retaliated against for reporting the harassment and may, as a result, take time off or lose promotions.

"Students and residents should be able to learn, study, and work without fear of harassment. Therefore, as the leaders of healthcare, we as AMA must take a stance. We cannot stay silent on this," Plenty said.

Two medical students shared stories of harassment on behalf of their survivor colleagues.

One recounted a survivor who was forced to skip classes, take "incompletes" for a semester, and receive counseling at the same center where a perpetrator was undergoing anti-sexual violence training, all while struggling with post-traumatic stress disorder.

A second survivor could not even find the contact information for the Title IX director, and after bringing the issue to a course director was repeatedly badgered to recount her experiences and name her perpetrator.

"By not passing this resolution, we disempower survivors and stand in the way of delivering timely and necessary justice," said Revati Gummaluri, speaking on behalf of the MSS.

Ross Goldberg, MD, speaking for the AMA Council on Legislation, said the proposed Title IX rules are indeed "controversial" in that they limit the scope of complaints to exclude off-campus incidents and limit an institution's ability to decide between a "preponderance of evidence" or a "clear and convincing evidentiary standard."

The rules also require live hearings and cross examinations during disciplinary proceedings -- something 40 higher education groups opposed in a , Goldberg noted.

That said, it appears the DOE under the Biden administration is already planning to amend the previous administration's rule and intends to publish its own rule in May 2022. That rule is expected to be "consistent with the priorities of the current administration," Goldberg said, which has already issued two executive orders on the matter -- one related to , and a second that aims to .

He called on the MSS to therefore revise the proposed call-to-action "so that the AMA is not calling on the Department of Education to do something we already know they are working on."

A proposed resolution aimed at strengthening Title IX protections to keep medical students and residents safe from sexual harassment and assault, in an amended form, was adopted on Monday.

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