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: None declared