Mistreatment of medical students has long been a problem nationwide and is not unique to any school. A recent study published in Academic Medicine, a publication of the Association of American Medical Colleges, assessed the prevalence of medical school mistreatment and the associated effects on burnout.
More Common Than You’d Think
Researchers surveyed a nationally representative sample of third-year medical students from 24 different medical schools. Over 600 completed the survey and the results were the following:
– 64% experienced at least one incident of mistreatment by faculty
– 76% experienced at least on incident of mistreatment by residents
– 10% reported experiencing recurrent mistreatment by faculty
– 13% reported experiencing recurrent mistreatment by residents
When compared with no or infrequent mistreatment, recurrent mistreatment was associated with higher burnout at 57% vs 33% when it occurred by faculty, and 48% vs 32% when it occurred by residents.
These rates, and others reported in literature over the recent years, are significantly higher than those reported by the Association of American Medical Colleges (AAMC) from their Medical School Graduation Questionnaire (GQ). The AAMC has stated that between 2000 to 2011, between 12% and 20% of students reported mistreatment—public humiliation, which is considered mistreatment by some, hit 34% in their 2012 GQ.
Challenges in Addressing Mistreatment
David P. Sklar, MD, in a letter from the editor published in Academic Medicine in May, discusses a conversation he had with residents about their mistreatment experiences, particularly by one doctor who had a reputation of mistreating his residents. When the school’s program director and chair of the department failed to handle it, Dr. Sklar attempted to approach them himself.
“As I related the story to them, it was as if I had dropped a dead rodent on the floor,” Dr. Sklar wrote. “They paid attention but did not want to touch it. Eventually they confirmed what the residents had said. The faculty member had his personality ‘challenges’ but provided good care, was a brilliant researcher…”
Dr. Sklar suggests that the problem not be considered “erratic, unpredictable, and part of human nature” and instead recommends that every possible incident of mistreatment be identified and viewed as predictable and potentially preventable. He also suggests focusing on the learning environment, better understanding the dynamics at work in the transitions of students and residents between social groupings, and establishing a longitudinal clerkship to mitigate constant transitions and increase connectedness between students and faculty.
Physician’s Weekly wants to know…do you agree with Dr. Sklar? Do you feel that medical student mistreatment is a problem? Do you know some doctor’s whose behavior is overlooked because of his/her value to the medical facility?
Source: Academic Medicine
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