Medical students still suffer mistreatment by faculty, resident doctors, and nurses, US report says
BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e7069 (Published 19 October 2012) Cite this as: BMJ 2012;345:e7069
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Do medical students suffer mistreatment at the hands of consultants? Or do they simply misinterpret proven teaching method as something more personal?
For me, Tanne’s article in November’s student BMJ raised this issue. The article discussed healthcare professionals and their experiences of different types of mistreatment. However, the majority centred around issues of verbal abuse. As students, are we truly mistreated, or do we just resent negative observations about our performance?
It appears important to first define what is meant by mistreatment. Is the mistreatment some students were quoting merely a short remark about their lack of enthusiasm, or was it the kind of inappropriate provocative comments that some of my female colleagues have experienced. There is, clearly, a massive gulf in severity between these two examples, and it is not possible to ascertain from the article a specific definition. Furthermore, does the definition of mistreatment and what is acceptable change between the UK and the USA? Stereotypically, the US is renowned for its ‘blame culture’, so is there simply a lower threshold for reporting abuse in the US than the UK?
We can consider that, given the similarities between our countries, this study is at least to some extent transferable. For those of us in the clinical years, I think we have almost all come across something that could be construed as mistreatment at some point. When this is developed into a teaching style, that is when we must question it’s impingement on our education as students. That said, who do we really learn more from? Personally, the old school consultants, the ones who, by the end of a session leave you feeling mentally drained, slightly dazed, but with a good deal more knowledge than you entered with, these are the ones that I favour. True, having one’s flaws pointed out on the ward round in front of ten colleagues may be a step too far, but we all work harder as a result of some degree of constructive criticism. Future motivation to prepare for THAT ward round with THAT particular consultant is never lacking, and answers forgotten at the key moment are rarely forgotten again. So what’s the problem?
Fried et al described a reduction in the number of complaints between the beginning of the third year of medical training and the end of the fourth year. It may well be that, over time, students come to terms with the verbal ‘bashings’. Or maybe, greater knowledge really does lead to less humiliation. Either way, sending these consultants on improvement courses seems unlikely to breach the generation gap. They are teaching how they were taught, so surely it is up to tomorrow’s doctors to make the necessary changes. Old dogs and all that...
Competing interests: No competing interests
It is one of the most important aspect of medical students. The pscyhological harassment the students undergo during their early years of student days is immense and sometimes eats into their personalities. In Indian scenario the fresh batch students face the problem of ragging from the senior students. Now it has become a punishable
offense. As these students cross the preclinical years and enter into the clinical studies, they face the problem of adjusting themselves to the eccentricities of their few teaching staff members. They are ridiculed and laughed at the mistakes they do in their clinical or surgical training. The students donot come out openly discussing these psychological problems because of the fear of facing examination when these teachers will be the internal examiners. This is partly because of the knowledge base of the students as well as lack of proper communication between the teacher and student. In other words there has to be teacher-student orientation before the start of the academic session what the students are expected to do, what the teachers expect from them and what the students want from the teachers. The students must also be introduced to other auxiliary staff or hospital personnel to develop a team spirit and to make them understand that team work is very essence of patient care and medical education. This problem of teacher-student relationship is more in postgraduate education in the beginning of the course. The problem is acute because there is an admixture of students who gain admission by merit and payment of donation. In spite of all these hurdles many students come out in flying colors establishing a strong relationship with their teachers. Few succumb to these pressures, become addicted to alcohol or drug abuse. It is different scenario in the west where the residents are taken for a ride in clinical rotation or internship. Yet medical education is a challenging profession where one gets molded and comes out with a strong personality to become a physician. Science teaches knowledge and relationships develop the personality, for medicine is a science and art. It equips the student with the knowledge and polishes the personality to be a humane physician.
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Re: Medical students still suffer mistreatment by faculty, resident doctors, and nurses, US report says
The professions are like fraternities and sororities, and hazing is part of the training. This hazing is a mixed blessing. It paradoxically promotes ego strength and esprit de corps, but it also promotes sadism and egotism. So we should temper this hazing with compassion, humility, and humor. Let’s remember that trainees are future colleagues, and they deserve our respect.
Competing interests: No competing interests