Each year thousands of students enroll in medical schools across the country. But just how many feel they've been disrespected, publicly humiliated, ridiculed or even harassed by their superiors at some point during their medical education?
Recently, researchers at Michigan State University were the first to analyze 12 years worth of national survey data from the Association of American Medical Colleges, or AAMC, questioning graduating students about their medical school experience during the clinical portion of their education.
They found that up to 20 percent of students reported some form of mistreatment each year. Additionally, only an average of 31 percent of those who indicated they were mistreated actually reported the incident to faculty or university administrators.
Public humiliation or belittlement topped the list, with sexist remarks and requests to do personal favors coming in second and third, respectively.
The research can be found online in the journal Academic Medicine.
Although the survey definition of mistreatment has evolved over the years, more recently, the meaning has focused on specific behaviors such as being disrespectful or humiliating others, as well as sexual, racial/ethnic, gender and sexual orientation mistreatment.
"The goal was really to uncover the nature of the problem and better understand what needs to be done to change these experiences," said Marsha Rappley, dean of the College of Human Medicine at MSU. "The feeling of mistreatment often happens in stressful environments like a clinical setting involving patients, and it's up to everyone to respond in ways that are respectful."
Recently, both the AAMC and the American Medical Association have acknowledged that mistreatment is an issue and should be addressed.
"If our students are experiencing these negative feelings, then everyone else is probably feeling uncomfortable as well," Rappley said, who is also the chair for the AAMC Council of Deans. "Not everything is polite and clean all the time, but if we think of the whole notion of education as treating people respectfully while giving them good feedback on their work, this could help build resiliency in moments where tempers may flare."
Rappley also said that proper safe reporting mechanisms are needed to ensure that students feel protected when reporting an incident.
"Across the country, med schools continue to look at ways to improve safe reporting practices whether it's using an ombudsman or implementing an online system," she said. "We all may be using different approaches, but ultimately it's about what makes the students feel safe."
By having serious discussions about specific behaviors that are perceived as disrespectful and offering up tools to help manage conflict and feedback, Rappley said that resident physicians and students could work even better as teams and help each other in intense situations.
"Collectively, we can figure out a solution," she said.
- Brian Mavis, Aron Sousa, Wanda Lipscomb, Marsha D. Rappley. Learning About Medical Student Mistreatment From Responses to the Medical School Graduation Questionnaire. Academic Medicine, 2014; 89 (5): 705 DOI: 10.1097/ACM.0000000000000199
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