Prominent GI oncologist Axel Grothey was forced out of Mayo Clinic for unethical sexual relationships with women he mentored

Three reprimands later, he retains leadership—and mentorship—positions

Share on facebook
Share on twitter
Share on linkedin
Share on email
Share on print

This article is part of The Cancer Letter's Ending Sexual Misconduct in Academic Medicine series.

The aftermath of sexual misconduct at premier medical institutions rarely leaves visible traces: HR is brought in, confidentiality invoked, deals made. The case of Axel Grothey’s exit from Mayo Clinic is a notable exception. 

Last year, the prominent gastrointestinal oncologist was reprimanded by medical licensure boards in three states for engaging in unethical sexual relationships with an oncology fellow and a faculty colleague at Mayo Clinic Rochester, his longtime place of employment. 

Three reprimands notwithstanding, Grothey has kept his appointment as co-chair of the NCI National Clinical Trials Network’s Gastrointestinal Steering Committee, an influential group that reviews ideas for clinical trials and helps determine the priorities in federally funded clinical research in GI oncology. 

After The Cancer Letter informed NCI officials about Grothey’s track record and requested comment, NCI Director Ned Sharpless removed him from the steering committee effective May 27.

“We cannot, and will not, tolerate sexual harassment within the agency, at research organizations that receive NIH funding, or anywhere else NIH-funded activities are conducted,” Sharpless said to The Cancer Letter. “ Based on the information we now have, I have, effective immediately, terminated Dr. Grothey’s membership on the NCI Gastrointestinal Cancer Steering Committee.”

Grothey’s publications haven’t skipped a beat. An editorial he wrote solo appeared in the New England Journal of Medicine. And he has published papers in The Lancet, the Journal of Clinical Oncology, and JAMA Oncology. According to PubMed, Grothey authored 32 publications in 2020, and 12 so far in 2021. His name figures on 12 abstracts that will be presented at the 2021 annual meeting of the American Society of Clinical Oncology next week. 

West Cancer Center, where Grothey landed as director of GI cancer research, has named him medical director of OneOncology Research Network, an organization that conducts clinical studies across a network of community oncology practices (The Cancer Letter, March 29, 2019).

If you were working at Mayo at the time of Grothey’s departure, chances are you wouldn’t have known why he had left. On May 31, 2018, an email to the Mayo faculty and staff said merely that Grothey “has decided to leave” for an unspecified destination and offered these arguably perfunctory parting words: “We wish Dr. Grothey well in his future endeavors.”

Documents obtained by The Cancer Letter during a six-month investigation make it possible to observe the sequelae of Grothey’s sexual misconduct, showing that the GI oncologist was, in fact, reported to Mayo’s Human Resources, which conducted an internal investigation. 

That investigation found that Grothey’s “pattern of conduct demonstrated a failure on his part to establish and maintain appropriate professional boundaries with people who viewed him as a mentor.” This finding was not made public, and Grothey was given a choice between resigning and being terminated.

The number of HR complaints against Grothey is not publicly known. The Cancer Letter doesn’t disclose names of individuals who have been subjected to sexual misconduct. 

Grothey’s misconduct came into public view for one reason only: 

Two women, both employed by Mayo, decided to take the extra step and moved their grievance outside the hospital system, to the Minnesota Board of Medical Practice, which launched a separate investigation. That investigation turned up evidence, generated files, and produced a reprimand that was ultimately published on the board’s website

The Minnesota reprimand then triggered investigations in Tennessee and Arizona, two states in which Grothey was also licensed to practice. These investigations generated hundreds of pages of documents. 

A timeline based on documents obtained by The Cancer Letter makes it possible to observe the final phase of Grothey’s career at Mayo, his actions at that institution, his departure, and his efforts to rebuild his career. 

Axel Grothey’s path of sexual misconduct, reprimands, and job changes

Feb. 2, 2018

Grothey is promoted

Axel Grothey, professor of oncology in the Mayo Clinic College of Medicine and Science at Mayo Clinic Rochester, is named chair of the Division of Hematology and Medical Oncology at Mayo Clinic Scottsdale. (Mayo Clinic Alumni Association announcement)

Grothey is issued a temporary medical license in Arizona, valid from Feb. 13, 2018-Oct. 21, 2018. (Temporary license approval )

Feb. 13, 2018
March 17, 2018

Promotion doesn’t happen

In an email, Stephen Alberts, chair of the Division of Medical Oncology, deputy director for clinical research at Mayo Clinic Cancer Center, writes: “Due to unforeseen circumstances, Axel Grothey will not begin his new role as Chair, Arizona Division of Hematology and Medical Oncology, In Arizona next week as originally anticipated.”

Later that day, a complaint from a colleague about Grothey is received by Mayo administration. (HR complaint )

The Minnesota Board of Medical Practice receives the first of two complaints filed by a Mayo colleague.

March 2018
April 3, 2018

Grothey is issued a medical license in Arizona. (Arizona MD profile page)

The Minnesota Board of Medical Practice receives the second of two complaints filed by a Mayo colleague.

May 2018
May 31, 2018

Grothey resigns from Mayo

An email from Mayo’s Alberts states: “Dr. Grothey has informed us that he has decided to leave Mayo Clinic effective May 30, 2018. We wish Dr. Grothey well in his future endeavors.” (Alberts’s email )

Sarah Cannon job is announced, but falls through

Grothey is appointed director of Gastroinestinal Cancer Research at Sarah Cannon Research Institute. The appointment is announced in a press release, but the job offer is retracted. (Businesswire press release)

May 31, 2018
Aug. 7, 2018

Lee Schwartzberg, the research institute medical director of West Cancer Center and chief medical officer of OneOncology, submits a recommendation to the Tennessee Board of Medical Examiners, in support of Grothey’s licensure. (Tennessee public records )

Tanios S. Bekaii-Saab, consultant within the Division of Hematology/Oncology and Department of Internal Medicine at Mayo Clinic Scottsdale, submits a recommendation to the Tennessee board, in support of Grothey’s licensure. (Tennessee public records )

Aug. 14, 2018
Aug. 15, 2018

“NO” #1

In his international graduate application for a medical license in Tennessee, Grothey responds NO to this question: “Have you ever had staff privileges at any hospital or health care facility that were ever revoked, suspended, curtailed, restricted, limited, otherwise disciplined, or voluntarily surrendered under threat of restriction or disciplinary action?” (Tennessee international graduate application )

Grothey lists West Clinic as employer

Grothey lists West Cancer Center as his intended place of employment in his application summary for Tennessee. (Tennessee practitioner questionnaire )

Aug. 15, 2018
Sept. 11, 2018

“NO” #2

In an application for a Tennessee license, Grothey responds NO to the following two questions:

— “Within the previous ten (10) years, have you ever had your hospital privileges revoked or involuntarily restricted for reasons related to competence or character by the hospital’s governing body?

— “Within the previous ten (10) years, have you ever been asked to or allowed to resign from or had any medical staff privileges restricted or not renewed by any hospital in lieu of or in settlement of a pending disciplinary action related to competence or character?

(Tennessee practitioner questionnaire )

“NO” #3

In an application for a Tennessee license, Grothey again answers NO to the following questions:

— “Within the previous ten (10) years, have you ever had your hospital privileges revoked or involuntarily restricted for reasons related to competence or character by the hospital’s governing body?

— “Within the previous ten (10) years, have you ever been asked to or allowed to resign from or had any medical staff privileges restricted or not renewed by any hospital in lieu of or in settlement of a pending disciplinary action related to competence or character?

(Tennessee practitioner questionnaire )

Oct. 8, 2018
Oct. 23, 2018

Tennessee board recommends denying Grothey a license

The Administrative Office of the Tennessee Board of Medical Examiners recommends that the board deny Grothey’s request for a license. The reason: he hasn’t completed U.S. residency training and isn’t ABMS certified. (Memorandum from the Tennessee Dept. of Health )

Tennessee board issues Grothey a license under a declaratory order

The Tennessee Board of Medical Examiners signs an order to issue Grothey a full, unrestricted license. In the Findings of Fact, the board cites Grothey’s work as a “mentor for numerous oncology fellows,” as part of its reasoning. The board also notes that Grothey received a teacher of the year award at Mayo Clinic seven times. (Final order from the Tennessee Dept. of Health )

Jan. 31, 2019
Apr. 3, 2019

NCI is informed about Grothey

One of the women from Mayo informs NCI about Grothey, who is a co-chair of National Clinical Trials Network’s Gastrointestinal Cancer Steering Committee. (Email to NCI )

NIH is informed about Grothey

One of the women from Mayo informs NIH about Grothey. (Email to NIH )

May 6, 2019
June 10, 2019

Grothey acknowledges misconduct to Minnesota investigators

Grothey meets with the Minnesota Board of Medical Practice committee to discuss the ongoing investigation. He acknowledges having had sexual relationships with two colleagues, including one fellow. “Respondent acknowledged that his sexual relationship with Colleague #1 was a ‘mistake’ and that he enhanced Colleague #1’s career through the work they did together. Respondent acknowledged having a sexual relationship with Colleague #2 and that he had sexual relationships with other coworkers. Respondent stated that he is serving as a mentor in his current employment.” (Minnesota stipulation and order )

Minnesota reprimands Grothey

The Minnesota Board of Medical Practice reprimands Axel Grothey for engaging in “unethical or improper conduct” and “respondent agrees that the conduct cited above constitutes a reasonable basis in law and fact to justify the disciplinary action.” He is fined $10,316.90 and is required to take a course on professional boundaries. (Minnesota stipulation and order )

Mar. 14, 2020
April 8, 2020

Grothey informs the Tennessee board about the reprimand

Grothey updates his mandatory practitioner profile questionnaire in Tennessee. He informs the board that he was reprimanded in Minnesota for a “romantic relationship with physician colleague who was undergoing a fellowship.” (Tennessee practitioner profile )

Grothey attends a three-day professional development course, “Maintaining Proper Boundaries,” offered by the Center of Professional Health at Vanderbilt University Center. (Tennessee consent order )

May 13-15, 2020
May 22, 2020

In Minnesota, Grothey petitions for “reinstatement of an unconditional license to practice medicine and surgery.” (Minnesota order of unconditional license )

Grothey informs the Arizona board about the reprimand

Grothey applies for license renewal in Arizona. He informs the Arizona Medical Board about the Minnesota reprimand. The document, obtained by The Cancer Letter, is heavily redacted. (Arizona Medical Board physician renewal questionnaire )

June 16, 2020
July 13, 2020

The Minnesota Board of Medical Practice’s Complaint Review Committee reviews Grothey’s petition and recommends reinstatement of an unconditional license. (Minnesota order of unconditional license )

Tennessee reprimands Grothey

The Tennessee Board of Medical Examiners reprimands Grothey for “unprofessional, dishonorable or unethical conduct.” The board fines Grothey a maximum of $2,000. Board members raise questions about why they didn’t know about Grothey’s conduct at Mayo at the time they issued him a license in Tennessee. He had answered “NO” repeatedly on questionnaires related to internal investigations. (Tennessee consent order , Video of the meeting)

July 29, 2020
Sept. 12, 2020

Minnesota Board of Medical Practice approves an unconditional license for Grothey to practice medicine and surgery in Minnesota. (Minnesota order of unconditional license )

Arizona reprimands Grothey

The Arizona Medical Board reprimands Grothey for “action that is taken against a doctor of medicine by another licensing or regulatory jurisdiction.” (Arizona reprimand , Notes from the board meeting )

Dec. 4, 2020
May 27, 2021

NCI removes Grothey from committee

NCI Director Ned Sharpless fires Grothey from NCTN’s GI Cancer Steering Committee, which he co-chaired.

All documents in the public record are also available in a 372-page PDF.

The investigation by The Cancer Letter shows that, in three separate questionnaires that Grothey filled out while trying to obtain a Tennessee license, he didn’t acknowledge having resigned as a result of an internal investigation at Mayo.

Earlier this week, when The Cancer Letter called Grothey to discuss his departure from Mayo, he first paused to close a door, presumably in his office. 

Before ending the conversation—stating that he wished to bring in an attorney—Grothey acknowledged the inappropriate sexual relationship with a fellow. 

“I feel very uncomfortable talking about this right now. What brought this up? This has upended my life so much. Why is this being brought up by The Cancer Letter right now?” Grothey said to a reporter. “Because, you know, things were actually settled, and everything’s done, and I’m not sure why this is coming up right now.”

The Cancer Letter sent Grothey a series of questions, which remained unanswered at deadline. The questions are available here.

“Mayo Clinic does not discuss personnel matters about current or former employees publicly. We have a well-established process for investigating and acting on concerns that employees may express about behavior in the workplace,” a Mayo spokesperson said to The Cancer Letter. “Mayo Clinic also complies with legal reporting requirements with regulatory boards when such reports are warranted.”

In a paper published in Mayo Clinic Proceedings last year, the institution summarized the handling of sexual harassment claims on its campuses in Rochester, Arizona, and Florida. 

The clinic reports having received 153 allegations between 2017 and 2019.

More than half of these allegations—88—were “substantiated following investigation and resulted in corrective action,” the paper states. 

Of these, 31—including nine physician-scientists—received formal coaching; 22—including three physician-scientists—received warnings; and 35—including 10 physician-scientists—were terminated from employment or resigned before termination. 

Notably, the paper doesn’t separate those who were terminated from employment and those who were allowed to resign under threat of termination.

The Cancer Letter asked Charanjit S. Rihal, chair of the Mayo Clinic Personnel Committee and the corresponding author on the paper, to explain the reasons for combining these two cohorts, and asking him to separate the data on those who were fired from those who were allowed to move to another, perhaps unsuspecting, institution.

Rihal didn’t respond to multiple emails.

Colleague #1 and Colleague #2 

A quote from the American philosopher, novelist, and poet George Santayana, translated into German, figures on the cover photo on Grothey’s Twitter bio: 

Wer sich nicht seiner Vergangenheit erinnert, ist verurteilt, sie zu wiederholen.” Those who cannot remember the past are condemned to repeat it.

Grothey appears to be a proponent of the #MeToo movement, Black Lives Matter, equitable health care, and other social justice issues, describing himself as a man “passionate about justice & tolerance, teaching & educating oncologists, caring for cancer patients, learning from mistakes.”

Documents assembled by Minnesota investigators identify one complainant against Grothey as “Colleague #1,” who was a second-year fellow when the sexual relationship with Grothey began. The other complainant, identified as “Colleague #2,” was also in a mentorship relationship with Grothey, documents state. 

Minnesota documents show that, at a meeting with state officials, Grothey expressed regret, noting that he had advanced the woman’s career:

“Respondent acknowledged that his sexual relationship with Colleague #1 was a ‘mistake’ and that he enhanced Colleague #1’s career through the work they did together. Respondent acknowledged having a sexual relationship with Colleague #2 and that he had sexual relationships with other coworkers. Respondent stated that he is serving as a mentor in his current employment.”

Grothey’s comment about having benefited the career of Colleague #1, if accurately conveyed in the Minnesota documents, may seem chillingly frank. 

“It used to be one of the perks of the job—the lab director, the department chair get to hunt around the new crop of female students, even undergraduates. You see it still, but, to me, it’s inexcusable that people don’t take the protection of the vulnerable seriously,” Arthur Caplan, The Drs. William F. and Virginia Connolly Mitty Professor and founding head of the Division of Medical Ethics at NYU School of Medicine in New York City, said to The Cancer Letter

Caplan said the state licensure boards in the U.S. don’t communicate with each other nearly well enough.

“Wouldn’t it be nice if we had a coordinated interstate system with all the information on it? It’s like saying, ‘I killed five people as a drunk driver in Massachusetts, but I’ll go get my license in Colorado now, because I don’t have to tell them,’” Caplan said. “What are we, in the age of Charles Dickens, writing things on scrolls of paper? It’s an electronic world, why aren’t we all linked?

“I’ll tell you why: Because they lobby against it.” 

The interstate system Caplan proposes would do nothing to root out misconduct among non-physician scientists and administrators, who aren’t required to hold state-issued licenses.

“It should be called sexual abuse if it’s a mentor-mentee relationship,” said Sidney Wolfe, co-founder of and senior advisor to Public Citizen’s Health Research Group, who has studied sexual misconduct by physicians. “It’s even worse for the mentees, because they have a clear tradeoff they believe they’re making if they complain, because by the time it gets taken care of, so to speak—they may have lost their chance to get into a residency, or if they are a resident, trying to get a fellowship, they’ve lost it.

“The reason it has not been in the news is obvious. Women are usually ashamed, embarrassed, horrified at making any of this public—and not a lot of medical boards have a range of ways in which they can complain to the medical board without going public,” Wolfe said to The Cancer Letter

The decision to report sexual harassment isn’t trivial, said Pamela Kunz, associate professor of internal medicine (medical oncology), director of the Center for Gastrointestinal Cancers, and vice chief of diversity, equity and inclusion for the section of medical oncology at Yale Cancer Center, who has been outspoken on this subject (The Cancer Letter, Oct. 2, 2020).

“It’s really hard for these women and other victims to even know where to go. Do they go to their ombudsperson or Title IX office? Do they go to the graduate medical education office? Do they go to their department leadership?” Kunz said to The Cancer Letter. “Many women get passed along from one person to another, and then there really isn’t accountability even within a system. And then there’s often a desire for institutions to protect the brand rather than protecting the individual.

“There’s a history of a lack of accountability. Institutions and perpetrators of sexual harassment need to be accountable,” Kunz said.

Trainees are vulnerable to sexual abuse and, as a rule, are unprotected by their institutions, said Pringl Miller, founder and president of Physician Just Equity, a nonprofit that  provides peer support for physicians who experience harassment, discrimination, and retaliation.

“Most women and/or the underrepresented in medicine suffering from harassment and/or discrimination, do not walk into those situations willfully,” Miller said to The Cancer Letter. “They find themselves in those situations because someone who has power over them abuses that power in the dependent and hierarchical relationships that exist in medicine. Victims feel powerless to defend themselves because of the very real consequences of having their careers derailed.”

“Survivors have to make a difficult decision weighing their safety, values, ethics and career over a temporary experience they don’t feel comfortable with,” Miller said. “Survivors find themselves asking—‘Am I willing to sacrifice my career over this? Or am I going to succumb to what is being asked of me? They reflect to themselves, ‘I’ve worked so hard to get to where I am—I’m not going to let this situation stand in my way.’” 

Shea Holman, director of law and policy at the Purple Campaign, a nonprofit focused on ending sexual harassment in the workplace, said many HR structures must be reworked to earn their employees trust. 

“We advise and advocate for having multiple reporting channels, and  making those reporting channels transparent, so that your employees actually know what their options are for reporting, where they can go, and whether they are anonymous or not,” Holman said to The Cancer Letter.

“Encouraging people to report is a huge part of addressing these issues and actually being able to bring people to justice when instances of sexual harassment have occurred.”

Clout within their institutions can make luminaries feel invincible, Holman said.

“Power can make an individual feel uninhibited, and thus more likely to engage in some sort of inappropriate behavior, and then lead to sort of coercive relationships, in which the individual feels that they can’t report, or they don’t want to report, because they are afraid of what’s going to happen to their career prospects, or they are afraid of some sort of organizational indifference or trivialization of the harassment.”

Caplan, Wolfe, Kunz, Miller, and Holman have no direct knowledge of the Grothey case.

A survey conducted by The Cancer Letter in 2020 shows that women who experienced gender bias and sexual harassment in academic medicine unanimously rated their institutions’ response as inadequate (The Cancer Letter, Oct. 2, 2020).

Women are increasingly stepping into leadership roles in oncology. A survey conducted by The Cancer Letter and the Association of American Cancer Institutes finds that fewer than 20% of cancer center directors are women, but women account for 40% of deputy and associate directors (The Cancer Letter, Oct. 9, 2020).

Grothey’s Scottsdale promotion collapses

Grothey’s downfall at Mayo occurred on the heels of a promotion.

On Feb. 6, 2018, Mayo announced that Grothey was named chair of the Division of Hematology and Medical Oncology at Mayo Clinic Scottsdale. 

Records show that he rented an apartment at Elite North Scottsdale, a place that, according to its website, is “seductively modern and newly renovated,” bustling with “elite energy,” and offering “spacious homes for agile lives.”

However, on March 17, an email from Stephen Alberts, chair of the Division of Medical Oncology and deputy director for clinical research at Mayo Clinic Cancer Center, said that Grothey would not begin his role in Arizona as planned. 

“Due to unforeseen circumstances, Axel Grothey will not begin his new role as Chair, Arizona Division of Hematology and Medical Oncology, in Arizona next week as originally anticipated. Please direct any questions or concerns you may have to me. Thank you, Steve.”

Documents obtained by The Cancer Letter show that later on the same day Mayo received a complaint about Grothey, and the complaint was passed on to Human Resources.

The complaint states: 

Several current/former women at Mayo (myself included) have enough concrete information to have him fired 5x over. 

Honestly, all Mayo would need to do is look into his email, pages, phone records, or use of Mayo funds, if they can even access any of this and are willing to deal with it head-on […] he has bragged that he brings in so much that he is “untouchable.”

Currently, we are all living in fear… we know he has been reported previously and has a history of retaliation, and we are all vulnerable due to our personal situations. I’m really putting everything out there by saying anything at all, and I’d prefer not to say anything else but to live in peace while Mayo leadership does its job. 

Based on everything I know, he is a huge liability to Mayo and should be let go as expeditiously as possible.

Six weeks later, in the morning of May 31, in an email to the faculty and staff, Alberts announces Grothey’s departure from Mayo:

Dr. Grothey has informed us that he has decided to leave Mayo Clinic effective May 30, 2018. We wish Dr. Grothey well in his future endeavors. We are in the process of communicating his departure to patients to ensure continuity of care.

The email to Mayo staff didn’t mention where Grothey might be going. That mystery cleared up later that afternoon, when Sarah Cannon Research Institute, a subsidiary of HCA Healthcare, announced in a press release that Grothey was named director of Gastrointestinal Cancer Research there.

The Sarah Cannon press release includes a quote from Grothey: “As a clinical researcher who has spent my career dedicated to advancing therapies for patients with gastrointestinal cancers, the mission of Sarah Cannon is firmly aligned with my goals and objectives. The opportunity to lead a program with access to a broad range of new therapies and a large number of patients is very exciting.”

Meanwhile, the buzz about Grothey’s departure from Mayo was spreading rapidly through the informal networks of oncologists, especially those working in GI.

Several physicians who, despite Mayo’s efforts to keep the matter confidential, were made aware of the circumstances and contacted Sarah Cannon leadership, The Cancer Letter has learned.

The offer to Grothey was retracted shortly after the press release was issued, sources said.

What it took to get a Tennessee license

The circumstances of Grothey’s departure from Mayo were still not publicly known.

However, unbeknownst to anyone but the principals, two women had already taken the matter outside Mayo’s walls and filed complaints to the Minnesota Board of Medical Practice, and its investigation had either begun or was about to. The board would take two years to complete the investigation and issue a reprimand.

State licensure boards and hospitals administer questionnaires that ask applicants whether they had ever been under an internal investigation or were allowed to resign as part of a deal with a hospital administration.

Grothey decided to obtain a license in Tennessee, but the challenge of getting a license there was formidable. 

Grothey did his residency outside the U.S. and was not certified by the American Board of Medical Specialties. In Tennessee, doctors like him have to petition for a “declaratory order” to be able to practice in the state. It would seem that the board would have scrutinized his application with particular care.

Two-and-a-half months after his resignation from Mayo—on Aug. 15, 2018—Grothey answers “NO” to the following questions on the Tennessee licensure application:

  • Have you ever had staff privileges at any hospital or health care facility that were ever revoked, suspended, curtailed, restricted, limited, otherwise disciplined, or voluntarily surrendered under threat of restriction or disciplinary action?

Three-and-a-half months after Mayo—on Sept. 11, 2018—Grothey answers “NO” to the following two questions on the Tennessee application: 

  • Within the previous ten (10) years, have you ever had your hospital privileges revoked or involuntarily restricted for reasons related to competence or character by the hospital’s governing body?
  • Within the previous ten (10) years, have you ever been asked to or allowed to resign from or had any medical staff privileges restricted or not renewed by any hospital in lieu of or in settlement of a pending disciplinary action related to competence or character? 

Four-and-a-half months after Mayo—on Oct. 8, 2018—Grothey once again answers “NO” to the same two questions on the Tennessee application: 

  • Within the previous ten (10) years, have you ever had your hospital privileges revoked or involuntarily restricted for reasons related to competence or character by the hospital’s governing body?
  • Within the previous ten (10) years, have you ever been asked to or allowed to resign from or had any medical staff privileges restricted or not renewed by any hospital in lieu of or in settlement of a pending disciplinary action related to competence or character? 

By submitting the three questionnaires, Grothey attested “to the truth of each statement made in said application,” documents show.

“A mentor for numerous oncology fellows”

On Oct. 23, 2018, citing Grothey’s status as an international applicant, the Tennessee Board of Medical Examiners denied his request for a license.

Grothey petitions the board to reconsider, asking for a declaratory order. Grothey’s CV, submitted to Tennessee officials, shows him winning seven teacher of the year awards while at Mayo. 

This is inconsistent with the Sarah Cannon press release and his biography which can be accessed on the OneR website. There, Grothey is said to have won five such awards. Without Mayo’s cooperation, which was denied to The Cancer Letter, it’s difficult to assess the significance of this discrepancy. 

Recommendations from two leaders in the field of GI oncology helped Grothey’s case in obtaining a Tennessee license.

One of the letters of recommendation came from Grothey’s current boss, Lee S. Schwartzberg, the research institute medical director of West Cancer Center, and chief medical officer of OneOncology.

Writes Schwartzberg:

It is my distinct honor to recommend Dr. Axel Grothey for medical licensure in the State of Tennessee. I have known Dr. Grothey for fifteen years and have observed his care of patients. He is an outstanding physician with a strong sense of integrity, remarkable intellect, and a caring compassionate nature. I recommend him for licensure with the highest possible enthusiasm.

Another letter of recommendation was submitted by Tanios S. Bekaii-Saab, a colleague of Grothey’s from Mayo Clinic Scottsdale: 

It is my pleasure to recommend Dr. Axel Grothey for medical licensure in the State of Tennessee. I have known Dr. Grothey for about 10 years, including as a Mayo Clinic colleague for the last two. Dr. Grothey has a great reputation amongst his patients and referring physicians as a highly competent, compassionate and caring physician. Dr. Grothey is one of the leading physicians and researchers.

Grothey received a full, unrestricted Tennessee license on March 19, 2019. The findings of fact supporting his licensure include the following:

Petitioner was a full professor at Mayo Clinic for eleven years and participated in training fellows. He acted as a mentor for numerous oncology fellows, and he was honored with a teacher of the year award at the Mayo Clinic on seven occasions.

Mentorship reassessed

Meanwhile, the investigation in Minnesota continued. 

On March 14, 2020, the Minnesota board published a more informative account of Grothey’s conduct at Mayo:

Respondent was a mentor to Colleague #1 while Colleague #1 was a fellow at the hospital. In the second year of Colleague #1’s fellowship, the relationship between Respondent and Colleague #1 became sexual. 

Respondent was a mentor to Colleague #2 when they began a sexual relationship. Colleague #2 ended the relationship and asked Respondent to cease contact. Respondent continued and sent a gift to Colleague #2’s home. 

The employer conducted an internal investigation which found Respondent’s “pattern of conduct demonstrated a failure on his part to establish and maintain appropriate professional boundaries with people who viewed him as a mentor.” 

The employer concluded that Respondent violated multiple policies and impacted the employment of the colleagues. Respondent resigned his employment after an employment committee recommended that he be terminated.

On June 10, 2019, Respondent met with the [Minnesota Board of Medical Practice] Committee to discuss his conduct. Respondent acknowledged that his sexual relationship with Colleague #1 was a “mistake” and that he enhanced Colleague #1’s career through the work they did together. 

Respondent acknowledged having a sexual relationship with Colleague #2 and that he had sexual relationships with other coworkers.

Respondent stated that he is serving as a mentor in his current employment.

Before cutting off his conversation with a reporter, Grothey confirmed this account of his departure from Mayo.

We cannot, and will not, tolerate sexual harassment within the agency, at research organizations that receive NIH funding, or anywhere else NIH-funded activities are conducted. Based on the information we now have, I have, effective immediately, terminated Dr. Grothey’s membership on the NCI Gastrointestinal Cancer Steering Committee.

Ned Sharpless

“I had a—let me close the door—I had a relationship with a fellow, whom I mentored, and that was inappropriate,” Grothey said to The Cancer Letter. “I mean, there was an investigation, and they said it was inappropriate behavior, and they threatened me with termination, and that’s why I left.” 

When asked whether he had ever been in a sexual relationship with someone he mentored, Grothey said, “Yes. That was the idea behind that.” 

Asked whether he had been in a sexual relationship with someone who reported to him, Grothey said, “I think I need to stop the interview right now, because, I mean, this is way beyond what I’m willing to talk about right now, without any lawyer.”

The Cancer Letter didn’t have an opportunity to ask why Grothey had—on three separate questionnaires—responded “NO” to questions, when, based on official documents and his own admission, the correct answer should have been “YES.”

In Minnesota, Grothey was reprimanded for “engaging in unethical or improper conduct,” fined $10,316.90, and ordered to take a “pre-approved course on professional boundaries, and professional ethics.” 

From May 12 to May 15, 2020, he took a three-day professional development course, “Maintaining Proper Boundaries,” over Zoom. The course is offered by the Center of Professional Health at Vanderbilt University Center.

“The course is designed to help clinicians who have had problems associated with maintaining proper sexual boundaries develop appropriate behaviors,” the course description states. “After participating in the Maintaining Proper Boundaries course, clinicians should be able to describe and discuss techniques for assessing personal potential for sexual boundary violations, strategies for recognizing the potential for sexual boundary violations in professional settings and approaches to avoiding sexual boundary violations.”

After Minnesota’s action, Grothey was also fined no more than $2,000 by Tennessee. Arizona also issued a reprimand, but didn’t impose a monetary fine. 

Public Citizen’s Health Research Group founder Wolfe says fines and reprimands of this magnitude are trivial. 

“In terms of looking at medical boards, reprimands and fines are a slap on the wrist,” Wolfe said. “If you look at the kinds of things that result in reprimands for many doctors, they’re the kinds of things that should cause them to lose their license.” 

“It’s not that we can do anything about it” 

After the Minnesota reprimand, Grothey was required to notify Tennessee and Arizona about the ruling.

“In the event Respondent resides or practices outside the State of Minnesota, Respondent shall promptly notify the Board in writing of the location of his residence and all work sites,” the Minnesota stipulation and order states.  

On April 8, 2020, nearly a month after the Minnesota reprimand, Grothey notified the Tennessee Board of Medical Examiners about the Minnesota ruling. Grothey updated his mandatory practitioner profile questionnaire:

Description of Violation: Romantic relationship with physician colleague who was undergoing a Fellowship.

Description of Disciplinary Action: License reprimanded with terms; assessed costs.

The Tennessee board reprimanded Grothey on July 29, 2020, for “unprofessional, dishonorable or unethical conduct,” and “disciplinary action against a person licensed to practice medicine by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed in this state.” 

The Tennessee board members asked why they had not looked closer at Grothey’s application when they reviewed his petition for declaratory order. 

“I just want to point out that this was somebody who came before us and was granted a license under a declaratory order, so they were looked at a lot closer. And not that we could have known,” board member Deborah Christiansen, a physician at East Tennessee Children’s Hospital, said at the meeting. “But obviously some of this was going on when we were looking at people’s accolades to grant this gentleman a license.

“It’s not that we can do anything about it, but it does bring to mind that when we grant a license we need to continue to scrutinize and look at that sort of thing,” she said.

Several Tennessee board members asked whether Grothey should be required to undergo additional evaluation.

It should be called sexual abuse if it’s a mentor-mentee relationship. It’s even worse for the mentees, because they have a clear tradeoff they believe they’re making if they complain, because by the time it gets taken care of, so to speak—they may have lost their chance to get into a residency, or if they are a resident, trying to get a fellowship, they’ve lost it.

Sidney Wolfe

“Essentially, we are, in essence, mirroring [Minnesota’s] discipline,” Angela Lawrence, executive director of the Tennessee board, said during the meeting. “Obviously, the civil penalties are not as high, and he’s already taken the professional boundaries course, so that’s why I’m not requiring him to do that again.”  

In light of these sexual misconduct allegations, Grothey’s continued role in leadership positions is concerning, said board member Stephen Lloyd, chief medical officer of Cedar Recovery, an addiction treatment company headquartered in Tennessee.

“These are really tough, when you get into these sexual boundaries cases, particularly where you have somebody in a superior position. We don’t have to look far in society to see that,” Lloyd said during the meeting.

“I’m extremely fine with us mirroring what Minnesota has done—but it doesn’t look like they followed all the way through, and got an evaluation of our doc here for any kind of sexual issues,” Lloyd said. “I would really challenge anybody that brought up, ‘Well we can’t do it because Minnesota didn’t do it,’ I certainly wouldn’t want to be a reciprocal state that took that attitude toward somebody that had, maybe, something we see on a national scale.” 

The subject of the three questionnaires was not brought up at the July 2020 meeting of the Tennessee licensure board. A video of the meeting is posted here

The Minnesota board granted Grothey an unconditional medical license on Sept. 12, 2020. He fulfilled the requirements of the Tennessee reprimand as of Sept. 14, 2020. 

Arizona mirrored Minnesota’s reprimand Dec. 4, 2020. James M. Gillard, an emergency physician and vice-chair of the Arizona Medical Board, questioned whether Grothey should be disciplined in the state, according to minutes of board discussions:

Vice-Chairman Gillard observed that this matter stemmed from action taken by the state of Minnesota against the licensee. He noted that other matters that resulted in the issuance of an Advisory Letter, that there was no patient care involved, and he questioned whether this matter warranted disciplinary action.

Others Arizona board members disagreed: 

Dr. [Lois E.] Krahn stated her concerns regarding the physician’s mentoring relationship with his colleagues with whom he was found to be involved, and she stated this could potentially affect the healthcare team.

Dr. [David C.] Beyer stated that the underlying issues raised in this Minnesota Board’s case involving the physician’s relationships with his mentees is serious and that he found disciplinary action was warranted in this matter.

Grothey now has unrestricted licenses in all three states.

Grothey co-chairs NCTN’s GI Steering Committee

Two women from Mayo reported Grothey’s behavior to NCI and NIH, documents obtained by The Cancer Letter show. 

They contacted NCI and NIH because—until Sharpless fired him on May 27, 2021—Grothey was a co-chair of the National Clinical Trials Network GI Steering Committee, a group that makes recommendations that can make (or break) careers of clinical researchers. 

The women were concerned: What does Grothey’s position to wield power on a federal level mean for them and others? 

The Cancer Letter has obtained two letters—one sent to NCI April 3, 2019, the other to the NIH Office of Grants and Funding on May 6, 2019. The letters are edited to remove identifying details.

In the letter to NCI, one of the women said:

First of all, I am writing to you from a personal email as I have faced prior institutional retaliation for reporting harassment internally […] and I don’t want to assume any more career risks, so please keep my identity confidential for now. 

My purpose for contacting you is that you were suggested to me as perhaps the best person to go with a concern shared by myself and several other women, on whose behalf I am writing.  

On a high level, we were victims of ongoing harassment and assault and career retaliation by an individual who holds multiple leadership roles associated with NCI, including currently chairing an NCI steering committee […]

Even though our own experiences were reported to our institution at the time […] which ultimately resulted in his dismissal from that institution, we are aware that he continues to hold these NCI-affiliated titles […]

We are collectively frustrated that (1) his former institution did nothing to prevent or respond to our individual incidences of harassment for many years until we faced the institution head-on as a group and gave them no choice, and (2) despite his termination, he still holds esteemed positions in NCI and continues to slander his victims in the scientific community, including attempting to undermine their career advancement.

I’m aware of NIH’s longtime and recently renewed verbal commitment to address sexual harassment and assault, but I’m not sure what the “right” process is to bring such information to NIH/NCI’s attention in a formal way, and what safeguards are in place for our protection if we do so.  

We have more than enough evidence and at least two of us are likely willing to talk, if it will result in some action that will prevent this from continuing, and if our protection could be assured.

If you are not the right person, could you please guide us (me, for now) to the right person or office?

An email response from a senior NCI official follows:

NIH does have a commitment to address sexual harassment in science and has recently updated its activities and efforts in this area. There is a general update about these efforts in a letter from Dr. Collins, dated Feb. 28, 2019, that is posted on the NIH website the following URL: 

https://www.nih.gov/about-nih/who-we-are/nih-director/statements/update-nihs-efforts-address-sexual-harassment-science.

There is a confidential avenue through which any concerns that sexual harassment is affecting NIH-funded research can be communicated to NIH and or the HHS Office for Civil Rights. The information on how to use this confidential channel of communication is described in Dr. Collins’s letter on NIH’s website, but I have also copied that section from his letter below with the associated email link.  

The letter refers to individuals who are principal investigators or other key personnel named on an NIH grant award, however, I think this avenue would be the best place for you to bring your concerns.

The NCI Steering Committees are not NIH grant awards; however, I believe the Chairs of the NCI Steering Committees do receive professional services compensation via a contract (the Steering Committees are administered by a different center at NCI from the branch/division in which I work), and the Steering Committees are involved in the evaluation of NIH/NCI-funded research, so this would seem to me the most appropriate communication channel for you to contact—at least to start the process. 

There may be additional information on the NIH Anti-Sexual Harassment website that may be of help to you as well at: https://www.nih.gov/anti-sexual-harassment.

I know NIH is working on creating additional ways for confidential sharing of information, as Dr. Collins’s letter states, and hopefully these new channels of communication will be available soon.

I hope this information helps you bring your and others’ concerns to the appropriate staff at NCI in the confidential manner that you need and I will certainly keep your identity confidential as you requested.

The complainant shared this correspondence with several colleagues. Subsequently, another woman sent a letter to the “grantee harassment” email address operated by the NIH Office of Extramural Research. 

I’m writing this email to report a concern about an individual who maintains a position of leadership within the NIH. I was advised that this would be the most appropriate mechanism to report this concern.

My concern is regarding Dr. Axel Grothey who currently serves as the co-chair for the Gastrointestinal Steering Committee within the National Cancer Institute. 

I was among multiple individuals who were victims of sexual harassment from Dr. Grothey while he was employed at my institution. This began when I was a trainee and continued for over a decade. As a result of his harassment, I lost mentorship, career advancement opportunities, and I faced a hostile work environment on a daily basis. 

During the years in which the harassment occurred, I was too embarrassed, ashamed, and frightened to come forward to my employer.  I feared more consequences that would further limit my career possibilities, since Dr. Grothey is a very influential figure in the field of GI oncology.  

However, not coming forward is also my greatest regret. He went on to sexually harass more individuals, some of whom are supporting me in writing this letter and who may wish to share their own experiences with you at the appropriate time. Although I often feared for myself and at times still do, I wish I could have come forward sooner as this may have prevented others from being harmed by Dr. Grothey and going through similar experiences. 

In early 2018, some of these individuals also came forward during an investigation that was conducted at my institution, which ultimately led to his resignation. The Minnesota Board of Medical Practice has also conducted their own investigation on this matter and the case is currently under review.

I am writing now with the intention of preventing other people from becoming victims of sexual harassment by Dr. Grothey. Given his longtime pattern of behavior to sexual harassment, I am very concerned that as long as Dr. Grothey remains in a position of leadership, the opportunity to harass another individual could easily happen again. 

I ask that my confidentiality be respected as Dr. Grothey has retaliated against a victim of his harassment in the past, which unfortunately led to very negative consequences for that individual. I would be willing to speak with anyone from your institution on this matter.

NIH wasn’t exactly helpful—the Office of Extramural Research sent an automated response and never followed up, the woman said.

Thank you for your correspondence in which you raise concerns about sexual harassment at your institution impacting NIH-funded research. NIH takes these concerns very seriously and plans to respond to this concern within the next 10-15 business days.

In the meantime, please note that NIH strongly encourages individuals to report allegations of sexual harassment or assault to the appropriate authorities, which may include your local police department or your organization/institution equal employment opportunity (EEO) or human resources offices. Individuals may contact the HHS Office for Civil Rights (OCR, https://www.hhs.gov/ocr/index.html) to obtain additional information and to file a complaint.

The NIH Director, Dr. Francis Collins, along with all of us at NIH are committed to addressing and eradicating sexual harassment in NIH-funded research. Please find additional information and resources on our Anti-Sexual Harassment webpage at https://grants.nih.gov/grants/policy/harassment.htm

We appreciate that you have brought these important issues to our attention.

Sincerely yours,

NIH Office of Extramural Research

On a webpage, NIH cautions that it “cannot take personnel or legal actions for non-NIH employees.” NIH also does not guarantee confidentiality for those who report someone. 

The page, “What to expect when notifying NIH,” explains how NIH follows up on complaints:

  • NIH will follow up with the relevant applicant/grantee institution to request information such as:
    • Timeline to investigate details of the complaint to ensure no affect on NIH funded work,
    • Restrictions on persons designated on an award (such as access to the institutional facilities) and how these may affect the supported research
    • Steps taken to assure that NIH-funded work is being conducted in a safe and harassment free environment,
  • OER will expect awardee institutions to provide a written response within 30 days of being notified.
  • OER will continue to work closely with the grantee institution to ensure they maintain a safe and harassment free work environment conducive of high-quality research.
  • NIH only shares information on a “need-to-know basis and will not share details of ongoing reviews.”
  • Confidentiality cannot be guaranteed.

Karyn Goodman, the remaining co-chair of the GI Steering Committee following Grothey’s termination, said the hierarchical structure of medicine is harmful. 

Power can make an individual feel uninhibited, and thus more likely to engage in some sort of inappropriate behavior, and then lead to sort of coercive relationships, in which the individual feels that they can’t report, or they don’t want to report.

Shea Holman

Goodman, who has no direct knowledge of the Grothey case, spoke with The Cancer Letter before he was removed from the steering committee.

“Academic medicine is, by design, a hierarchy. Since we have historically had more men in senior positions, it creates an inherent power differential that has put women in junior ranks at a disadvantage,” said Goodman, professor and vice chair for research and quality in the Department of Radiation Oncology at the Icahn School of Medicine at Mount Sinai, and associate director for clinical research at The Tisch Cancer Institute. 

“I have seen this play out in so many ways in terms of gender discrimination and sexual harassment, and because the top level of decision-makers are also men, they are often willing to overlook the misbehavior when it is reported,” she said. 

The GI Steering Committee is responsible for making junior faculty feel safe, she said. 

“As leaders in academic medicine, we need to promote a safe environment for our junior faculty and hold people accountable for their transgressions,” Goodman said. 

“The NCI, in particular, should be the paragon of virtue when it comes to equity issues and set the standard high for the rest of academic medicine to follow.”

Paul Goldberg
Editor & Publisher

YOU MAY BE INTERESTED IN

NIH has until Feb. 20 to comply with a congressional subpoena that directs NIH Director Monica Bertagnolli to produce internal documents, including reports and whistleblower complaints that could shed light on whether NIH is adequately responding to complaints of workplace misconduct and sexual harassment. 
Paul Goldberg
Editor & Publisher

Login