Abstract
BackgroundMedia exposés and academic literature reveal high rates of bullying and harassment of medical students, most commonly by consultant physicians and/or surgeons. Recent reports reveal the medical profession to be characterised by hierarchy, with verbal abuse a ‘rite of passage’, as well as sexist and racist behaviours.MethodsSemi-structured in-depth interviews were conducted with ten current or recently graduated medical students from Sydney-based medical schools. Interviews were audio-recorded, transcribed verbatim, and thematically analysed.ResultsHierarchy, and a culture of self-sacrifice, resilience and deference, were identified as problematic elements of the medical profession. In the minds of participants, these factors created barriers to reporting mistreatment, as participants felt reporting led to being labelled a ‘troublemaker’, affecting career progression. Additionally, participants stated that avenues of recourse were unclear and did not guarantee confidentiality or desired outcomes.ConclusionsMistreatment is continuing in clinical teaching and has negative consequences on medical students’ mental health and learning. Structural change is needed to combat institutionalised mistreatment to ensure the wellbeing of future doctors and high quality patient care.
Highlights
Media exposés and academic literature reveal high rates of bullying and harassment of medical students, most commonly by consultant physicians and/or surgeons
Hierarchy in medicine today is characterised by an imbalanced relationship between superior and subordinate, rather than a mentoring relationship between teacher and learner [1]
Cases of doctors being bullied out of specialty training programs, hospitals stripped of training accreditation, and declining mental health of medical trainees, are all purportedly products of the exigent culture within medicine [4,5,6,7,8]
Summary
The participant sample comprised ten current or recently graduated medical students (three men and seven women) of metropolitan, rural and international backgrounds (see Table 1). Jarra and Abby said the expectation in medical school, due to the unpredictable timetable, is that you’re not employed, which they found unreasonable They believed the uncertainty medical students suffered with ‘He always referred to doctors as ‘him’ or ‘he’, so always in the male version... The one international participant, Arosh, had not experienced any racism, while New Zealand-born Indian Sanjna, she’d experienced racism, believed it was a societal problem no more prevalent in medicine than anywhere else She reported ‘skinny, white, blonde’ female students were more likely to suffer sexual harassment because of conventional beauty standards. Mistreatment from patients Eight participants reported witnessing or experiencing sexist or racist comments from patients, such as female medical students being assumed to be nurses, sexualising comments, or international students being criticised for ‘Obviously I don’t enjoy patients being like, “I’ll have the pretty blonde one”, but can you really educate every single person who comes through the hospital?’ (Lily).
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