Medical student abuse during clinical clerkships in Japan

  • Shizuko Nagata-KobayashiEmail author
  • Miho Sekimoto
  • Hiroshi Koyama
  • Wari Yamamoto
  • Eiji Goto
  • Osamu Fukushima
  • Teruo Ino
  • Tomoe Shimada
  • Takuro Shimbo
  • Atsushi Asai
  • Shunzo Koizumi
  • Tsuguya Fukui
Original Articles


OBJECTIVE: To assess the prevalence of medical student abuse during clinical clerkships in Japan.

DESIGN: A cross-sectional questionnaire survey.

SETTING: Six medical schools in Japan.

PARTICIPANTS: Final year (sixth-year) and fifth-year medical students in the period from September 2003 to January 2004. From a total of 559 students solicited, 304 (54.4%) returned the questionnaire, and 276 (49.4%: 178 male and 98 female) completed it.

MEASUREMENTS: Prevalence of medical student abuse in 5 categories: verbal abuse, physical abuse, academic abuse, sexual harassment, and gender discrimination; differences in abusive experience between male and female students; types of alleged abusers; reporting abusive experiences to authorities; and emotional effects of abusive experiences.

RESULTS: Medical student abuse was reported by 68.5% of the respondents. Verbal abuse was the most frequently experienced abuse (male students 52.8%, female students 63.3%). Sexual harassment was experienced significantly more often (P<.001) by female students (54.1%) than by male students (14.6%). Faculty members were most often reported as abusers (45.2% of cases). Abuse occurred most frequently during surgical rotations (42.0% of cases), followed by internal medicine (25.1%) and anesthesia rotations (21.8%). Very few abused students reported their abusive experiences to authorities (8.5%). The most frequent emotional response to abuse was anger (27.1% of cases).

CONCLUSIONS: Although experience of abuse during clinical clerkships is common among medical students in Japan, the concept of “medical student abuse” is not yet familiar to Japanese. To improve the learning environment, medical educators need to take action to resolve this serious issue.

Key words

clerkships education Japan medical student abuse questionnaire sexual harassment 


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Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  • Shizuko Nagata-Kobayashi
    • 1
    Email author
  • Miho Sekimoto
    • 2
  • Hiroshi Koyama
    • 1
  • Wari Yamamoto
    • 3
  • Eiji Goto
    • 4
  • Osamu Fukushima
    • 5
  • Teruo Ino
    • 6
  • Tomoe Shimada
    • 7
  • Takuro Shimbo
    • 1
  • Atsushi Asai
    • 8
  • Shunzo Koizumi
    • 7
  • Tsuguya Fukui
    • 9
  1. 1.Department of General Medicine and Clinical EpidemiologyKyoto University Graduate School of MedicineKyotoJapan
  2. 2.Department of Healthcare Economics and Quality ManagementKyoto University Graduate School of MedicineKyotoJapan
  3. 3.Department of Community and General Medicine Graduate School of Medicine, Program of Community Health and Comprehensive Medicine, Division of Community and Comprehensive Medicine, Clinical EpidemiologySapporo Medical University School of MedicineHokkaidoJapan
  4. 4.Department of Medical EducationYokohama City University School of MedicineKanagawaJapan
  5. 5.Office of Educational Developmentthe Jikei University School of MedicineTokyoJapan
  6. 6.Department of MedicineFujita Health University School of MedicineAichiJapan
  7. 7.Department of General MedicineSaga University HospitalSagaJapan
  8. 8.Department of Bioethics, Faculty of Medical and Pharmaceutical ScienceKumamoto UniversityKumamotoJapan
  9. 9.St. Luke International HospitalTokyoJapan

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