This week, medical social media spheres have been buzzing with perspectives regarding New York Times Well Blog piece, The Bullying Culture of Medical School. The piece, written by Dr. Pauline Chen (@paulinechen), surgeon and author of the Times’ Doctor and Patient column, recounts a particular incident in medical school where students were both physically and psychologically bullied by a resident. While insightful and moving, this is not the first attempt to put a face on the staggering number of medical students and junior physicians who report experiencing some sort of “bullying” during their training.
Physicians, residents, and students alike took to a recent #MedEd Tweet Chat to air their own experiences, opinions, and suggestions about decreasing bullying within the medical education system. The current hierarchical education system involves a sort of “totem pole” in which the least experienced team members rely on their respected superiors for grades, recommendations, and overall career advancement. This dependence makes it extremely difficult for students and junior residents to take stand when their attending physician, their teacher, steps out of line.
My own experiences with physician bullying are extremely limited. I’ve never been passed over because of my gender, physically assaulted, or called names by anyone. In fact, my residents and attending physicians have all been very kind and extremely dedicated to a mindful education process. I have a few intuitive guesses that may explain it. Those who are not as willing to teach effectively probably self-select themselves out of large teaching programs. Additionally, my superiors have recounted their own stories of bullying and unprofessionalism, and have stated their desires to act as better example for the next generation of physicians.
That’s not to say bullying doesn’t exist and that the system doesn’t need a tune-up. Nearly every single one of my rotations has involved a clerkship director stating that students are encouraged to report any instances of unprofessional behavior immediately so the situation can be remedied accordingly. Although these directors, who ultimately assign grades, assure students that there will be no academic repercussions, many students still feel uncomfortable with this process. To eliminate this hesitance, my institution has developed an anonymous reporting system for unprofessional behavior and bullying. While I have not personally used this system, I do have classmates who view this system as a valuable resource.
In my mind, the final obstacle to remedying bullying and unprofessional behavior is a lack of repercussion. If a respected chairman of a department acts in an inappropriate manner, students feel as though their grievances will carry little weight against the offender’s reputation, academic accolades, and financial contributions to the institution. With that said, I am fully aware of faculty members who have been barred from working with students and residents as punishment for their behavior, but until students and residents feel as though their grievances can make a difference at all levels, unprofessional conduct will go under-reported.
- Well: Doctor and Patient: The Bullying Culture of Medical School (well.blogs.nytimes.com)
- Do med school interviews favor extroverts? (futurity.org)
- Study: Clerkship Grading Varies ‘Dramatically’ at U.S. Medical Schools (usnews.com)
- We are role models (medrants.com)