Medical students are being failed by a system that won’t take responsibility

That’s according to a British Medical Association survey published on Friday – and the testimony from students reminds us that the problem goes far deeper than the statistics alone.

The BMA, working with Surviving in Scrubs, surveyed 968 medical students across the UK in March and April 2025 about their experiences of sexism and sexual violence.

Forty-one per cent of female respondents and 19 per cent of male respondents reported experiencing sexual harassment or assault at medical school, with 84 per cent believing sexism is a problem in medical education.

But it’s what happens when students try to seek help that really drives home the nature of the institutional failure.

67 per cent chose not to report incidents – often because they believed “nothing would be done.”

Of those who did report, 75 per cent were dissatisfied with the outcome. And 60 per cent said they didn’t trust their medical school to handle future incidents adequately.

Institutional neglect

The testimony is bleak. One student is quoted as saying:

Our university allowed a repeated predator who sexually assaulted other students back onto the course. They encouraged victims not to go to the police as it would impact their reputation.

Another describes their experience of reporting:

When I went to report this to a senior member of staff at my university, I was told it might reflect poorly on my professionalism if I told the medical school I had been assaulted by another student but refused to reveal their identity. There was no way to anonymously report this, and I felt too scared to report it non-anonymously. I later ended up in classes with my assaulter because there was no anonymous reporting process.

Another student from the South of England explains what cultures within cultures can be like:

When I first went to the university for help, I was told not to report it and to ‘keep it in the family’ – that we keep these things within the medics. The promised safeguards never happened, he remained in my classes, and the only outcome was that I was labelled ‘unprofessional’ and ‘difficult to work with’ – labels that can severely tarnish your career as a doctor.

These aren’t accounts of universities struggling with tricky cases – they are descriptions of institutions actively working against students who report harassment, warning them about career damage, and protecting perpetrators to avoid reputational harm.

The clinical placement black hole

Twenty per cent of female medical students – and six per cent of male – told the BMA they’d been harassed or sexually assaulted specifically while on clinical placement. Sixty-nine per cent of female students experienced sexism on placements.

The perpetrators included senior doctors, consultants, NHS staff, patients. One student recounted:

A male patient said, ‘lucky me, three attractive women down on their knees for me.’ We all felt so uncomfortable, and I expected the doctor to say something, but she just laughed awkwardly, and we carried on. It was as if this was an accepted part of the job, and it would be rude or unprofessional to call out the inappropriate sexualisation.

The problem isn’t just the harassment – it’s that students don’t know who to complain to, and when they try to report, they find themselves caught between institutions that each claim it’s not their responsibility. Another student:

Students are left to fall through the cracks. While we are held to the same professional standards as doctors, this professional status does not extend to our safeguarding. We work in NHS hospitals without the protections afforded to NHS staff. Meanwhile university processes are not geared to handle what happens on placement.

Another describes being pinballed around:

When I tried to raise concerns, it was a struggle to find the right support. Some people washed their hands of it because it was not within their remit, and I had to disclose repeatedly to find a supportive advocate.

The Medical Schools Council acknowledges the issue directly:

Clinical placements present particular challenges, as students often work in environments where those responsible for harassment are not employed by their university. This creates multiple, sometimes fragmented, reporting systems across different providers.

It calls for “a uniform reporting and support system” and notes that medical schools will work with NHS partners to develop “a more coordinated strategy.”

In other words, we’ve got a split responsibility system where universities are responsible for students but don’t employ the people harassing them on placements, NHS trusts supervise students but don’t feel they answer to universities, and students fall through the gap while perpetrators – particularly senior clinicians – face little accountability.

Where’s the Office for Students?

In England, OfS Condition E6 requires universities to publish comprehensive policies, provide training, operate multiple reporting channels including anonymous routes, ensure credible and fair investigations, and provide appropriate support.

The BMA testimony suggests that there’s work to be done. Students here report a lack of anonymous reporting mechanisms, being told reporting might damage their “professionalism”, that they’re studying alongside perpetrators, and that universities are discouraging police reports.

Placements are clearly a problem. E6 places responsibility on universities to protect students, including when harassment happens “outside of the provider context”, and Paragraph 17 of the OfS guidance acknowledges that “a provider may have less influence over harassment and sexual misconduct by individuals who are not students or staff” – but says universities should still:

…be able to take significant and credible steps to protect students through supporting those who experience harassment or sexual misconduct even if this takes place outside of the provider context.

But it doesn’t create obligations for placement providers, doesn’t mandate coordinated reporting between universities and NHS trusts, doesn’t clarify who students should complain to when harassed by a consultant, and doesn’t solve the problem of perpetrators who aren’t subject to university disciplinary processes.

The only mention of placement providers in the entire guidance is a suggestion that universities might:

…consider how to best prevent the use, enforcement and/or reliance on non-disclosure agreements (NDAs) in matters relating to harassment and/or sexual misconduct by third parties, such as placement providers.

It’s a regulatory framework designed for students on campus, interacting with university staff. It fundamentally fails to account for how medical education – and nursing, teaching, and social work education – actually works.

You might be able to make an argument for OfS’ approach over courses where work-based learning elements are small. But given the huge amount of time spent on placement by health students, that there wasn’t (or doesn’t seem to have been) any coordination with other regulators or industry bodies isn’t really forgivable.

What the BMA wants

The report’s first recommendation is controversial for some:

The Government to bring forward legislation that introduces a statutory duty of care on higher education institutions for their students.

Not better policies or improved guidance, but legal accountability that clarifies who’s responsible and creates grounds for enforcement.

Other recommendations include medical schools agreeing clear, tough sanctions for sexual violence, multiple reporting channels including anonymous routes, measures to minimise contact between complainants and accused, and signing NHS England’s Sexual Safety Charter.

The Royal College of Surgeons noted that only five medical schools have signed the charter, and called for the Department of Health and Social Care to establish “a national, independent, and anonymous reporting mechanism.”

Emma Runswick, BMA deputy chair of council:

The lack of accountability coupled with the power imbalance for perpetrators, especially when they are senior doctors, can lead to the normalisation of sexist and inappropriate behaviours in the NHS and beyond.

Becky Cox and Chelcie Jewitt of Surviving in Scrubs:

This deeply shocking data shows the appalling scale of sexual violence affecting medical students in the UK perpetrated not only by fellow students but also senior university and medical staff responsible for their training. When incidents occur students are repeatedly failed and re-traumatised by the organisations meant to protect them.

What we’ve come to understand through the high profile cases is that students are especially vulnerable to these sorts of abuses outside of formal “direct academic or professional responsibility” in tight-knit and/or professional environments.

I’m thinking things like small departments; Oxbridge colleges; schools that train the professions; placements and fieldwork; and the performing arts in general.

In many ways, the power imbalance between students and perpetrators is reflected structurally in each of those examples – all of which also seem to involve those that a university finds untouchable for whatever reason.

Resolving those imbalances shouldn’t be beyond universities working carefully with partners to risk-assess different sorts of student in different sorts of settings. But it really does need a risk assessment-based approach.