By NIRAN AL-AGBA, MD

The University of Southern California (USC) appears to look the other way when male physicians harass or assault women. In reality, sexual violence spares no occupation, including medicine, but the way an organization responds to crime against women indicates a certain level of integrity. The World Health Organization estimates sexual violence affects one-third of all women worldwide. In a nation where women make up 50% or more of each incoming medical school class, only sixteen percent of medical school deans are female, making gender imbalance in leadership positions nearly impossible to overcome.

For the second time in less than a year, USC President C.L. Max Nikias is grappling with sexual misconduct allegations against a physician faculty member. Complaints go back to the early 1990s from staff and patients about inappropriate comments and aggressive pelvic exams done by Dr. George Tyndall, the only full-time gynecologist for the past three decades at the campus clinic. USC ignored complaints until a nurse contacted the campus rape crisis center.

Dr. Tyndall was initially suspended pending inquiry and forced to resign shortly thereafter. More than 100 complaints have been received and five are suing USC. Astonishingly, the founded complaints against Dr. Tyndall were never turned over to authorities or reported to the Medical Board of California. USC defended this decision, asserting there was no legal obligation to report misconduct. USC has a moral and ethical duty to protect students, staff, and faculty, yet failed on both counts.

USC is no stranger to scandal. In 2007, Dr.  Carmen Puliafito, MD, a Harvard Medical School graduate, was chosen as Dean at the USC School of Medicine. His background held clues he would cause trouble. Just prior to arrival at USC, Puliafito settled a lawsuit for throwing a “tantrum” and committing assault and battery against an optometrist named Marc Brockman at the University of Miami. During the trial, Miami University disclosed they had previously investigated sexual harassment complaints against Puliafito too.

Puliafito was a strategic fundraiser, bringing in over $1 billion in donations for the Trojans; however, he kept company with criminals and documented his illicit drug use on video. His nightlife came to screeching halt when a 21-year-old female companion overdosed in a Pasadena hotel room and an ambulance transported her to the hospital. Police confiscated more than 1 gram of methamphetamine from the hotel room, but inexplicably, no police report was filed until three months later identifying Puliafito as a witness to the overdose.

An anonymous witness phoned the office of the USC President Nikias and reported Puliafito’s activities.  Ten days later, Puliafito resigned, however President Nikias never filed a complaint with the California Medical Board or the authorities. When the LA Times discovered Puliafito was still practicing as part of the USC faculty, President Nikias issued a ‘mea culpa’ admitting “they could have done better.” Unfortunately, his next choice was anything but better.

Dr. Rohit Varma succeeded Puliafito as Dean at the School of Medicine but resigned amid scandal after less than a year. He had settled a sexual harassment claim in 2003 and was disciplined by USC. Varma – then a 40-year-old junior professor – attended a conference with a young international student he was supervising. He allegedly told his student that the grant they were travelling on only supported staying in a single shared room. When the student protested, Varma took her phone and threatened to have her visa revoked. USC reached a $135,000 settlement with the woman, of which Varma paid $11,000. He was ordered to complete sexual harassment counseling and denied a promotion, yet one year later, earned full professorship, as if nothing ever happened.

Is USC defending “bad boys” with little regard for women? Or is there something else going on? One might argue that threatening your subordinate with visa revocation is borderline sociopathic. Are they being protected because they are physicians or simply because they are men?

The only way to answer this question is to look at what happens when a female physician and male physician have a hostile interaction. One evening, Dr. Meena Zareh, a cardiology resident at USC, reported being summoned to a windowless call room by Dr. Guillermo Cortes, her direct supervisor, to discuss a patient. When she attempted to leave, Dr. Cortes allegedly overpowered her, blocked the door, and assaulted her. Dr. Zareh shared the incident with a co-worker afterward but did not report it to law enforcement or the residency program for fear of reprisal until three months later. Dr. Cortes denied allegations and was placed on administrative leave pending investigation.

Dr. Cortes was allowed to return to work but was barred from unsupervised contact with Dr. Zareh. Reprisals toward Dr. Zareh began almost immediately, a signal of mounting institutional pressure to sweep her allegations under the rug. One male supervisor suggested she take a leave of absence, while others recommended deferring fellowship training or changing residency programs. Dr. Zareh is suing USC and LA County for mishandling her report of sexual assault, a mistake in which USC seems to be accumulating expertise. If the pattern holds, Dr. Cortes will get a promotion, a raise, and may become a future Dean at the Keck School of Medicine.

While double standards remain alive and well in academia, there are rays of hope. Dr. Laura Mosqueda, a geriatric physician, is one of those. She is the first woman chosen to lead the Keck School of Medicine since it was established in 1885. It is about damn time.  In the race to become a top-tier program, I have no doubt Dr. Mosqueda will achieve a great deal more than her predecessors.  After all, how could she do any worse?

Niran Al-Agba (@silverdalepeds) is a third-generation primary care physician in solo practice in an underserved area in Washington State who blogs at peds-mommydoc.blogspot.com.