1 in 5 med students reports maltreatment

"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," says Marsha Rappley. (Credit: iStockphoto)

Up to 20 percent of medical students report some kind of mistreatment each year, say researchers who analyzed 12 years of national survey data. This mistreatment could include disrespect, public humiliation, ridicule, or even harassment.

Additionally, only an average of 31 percent of those who indicated they were mistreated actually reported the incident to faculty or university administrators.

The researchers were the first to analyze the survey data from the Association of American Medical Colleges, or AAMC. The survey asked graduating students about their medical school experience during the clinical portion of their education.

Public humiliation or belittlement topped the list, with sexist remarks and requests to do personal favors coming in second and third, respectively.

The research is available online in the journal Academic Medicine.

Med student experience

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,” says Marsha Rappley, dean of the College of Human Medicine at Michigan State University.

“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.”

When tempers flare

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 says, 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 says 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 says. “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 says 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 says.

Source: Michigan State University