Abstract
Medical training can—and often does—perpetuate mistreatment. Data from the Accreditation Council for Graduate Medical Education (ACGME) survey during the last 20 years suggest that the majority of medical students experience one or more incidents of mistreatment by the time they graduate. Subordinates in hierarchical medical culture report that those charged with their training have belittled or mocked them, sexually harassed them, overlooked or ignored them, or rendered biased grades or evaluations due to their training status or based on their gender, race, ethnicity, religion, sexual orientation, age, or handicap. Mistreatment is likely to contribute to work-related distress (burnout), which can negatively affect patient care. In addition, burnout often causes mistreatment; physicians who are not well are at higher risk for mistreating the learners they supervise. A comprehensive, stepped approach to prevent and mitigate harm from learner mistreatment in medical training will ideally focus first on awareness and rehabilitative education. Well-conceived programs will recognize the virtue of zero tolerance for abuse coupled with the virtue of a compassion-driven approach to mitigate educator distress that perpetuates risk for learner mistreatment.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Association of American Medical Colleges. (2016, July). Medical school graduation questionnaire: 2016 all schools summary report. Retrieved June 2017, from AAMC: https://www.aamc.org/download/464412/data/2016gqallschoolssummaryreport.pdf
Bynum WE, Lindeman B (2016). Caught in the middle: a resident perspective on influences from the learning environment that perpetuate mistreatment. Acad Med 91: 301–304.
Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD (2014). The prevalence of medical student mistreatment and its associating with burnout. Acad Med 89: 749–754.
Crutcher RA, Szafran O, Woloschuk W, Chatur F, Hansen C (2011). Family medicine graduates’ perceptions of intimidation, harassment, and discrimination during residency training. BMC Med Educ 11: 88.
Davis J. (2016, July). We analyzed 35,000 physician salaries. Doximity (blog). https://blog.doximity.com/articles/we-analyzed-35-000-physician-salaries-here-s-what-we-found.
Fnais N, Soobiah C, Chen MH, Lillie E, Perrier L, Tashkhandi M, Straus SE, et al. (2014). Harassment and discrimination in medical training: A systematic review and meta-analysis. Acad Med 89: 817–827.
Fried JM, Vermillion M, Parker NH, Uijtdehaage S (2012). Eradicating medical student mistreatment: A longitudinal study of one institution’s efforts. Acad Med 87: 1191–1198.
Haglund ME, aan het Rot M, Cooper NS, Nestadt PS, Muller D, Southwick SM, et al. (2009). Resilience in the third year of medical school: A prospective study of the associations between stressful events occurring during clinical rotations and student well-being. Acad Med(84: 258–268.
Lau JN, Mazer LM, Leibert CA, Merrell SB, Lin DT, Harris I. (2017, July) A Mixed-Methods Analysis of a Novel Mistreatment Program for the Surgery Core Clerkship. Acad Med 92(7) : 1028–1034.
Mullan CP, Shapiro J, McMahon GT (2013, March). Interns’ experiences of disruptive behavior in an academic medical center. Journal of Graduate Medical Education: 25–30.
Petersdorf RG. Student Mistreatment. Association of American Medical Colleges. Washington DC. 28 July 1992. Memo. https://www.aamc.org/members/gsa/54690/gsa_mistreatment.html
Richman JA, Flaherty JA, Rospenda KM, Christensen ML (1992). Mental health consequences and correlates of reported medical student abuse. JAMA 267(5): 692–694.
Rosenberg DA, Silver HK (1984, Feb). Medical Student Abuse: An Unnecessary and Preventable Cause of Stress. JAMA 251(6): 739–742.
Smith-Coggins R, Prober CG, Wakefield K, Farias R. (2017, April). Zero Tolerance: Implementation and Evaluation of the Stanford Medical Student Mistreatment Prevention Program. Acad Psychiatry 41(2): 195–199.
Silver HK. (1982). Medical students and medical schools. JAMA 247: 309–310.
Silver HK, Glicken AD (1990). Medical Student Abuse. Incidence, Severity, and Significance. JAMA 263: 527–532.
Whitgob EE, Blankenburg RL, Bogetz AL (2016). The discriminatory patient and family: strategies to address discrimination towards trainees. Acad Med 91: s64–s69.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Rainey-Clay, J., Smith-Coggins, R. (2019). Mistreatment. In: Weiss Roberts, L., Trockel, M. (eds) The Art and Science of Physician Wellbeing. Springer, Cham. https://doi.org/10.1007/978-3-319-42135-3_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-42135-3_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-42134-6
Online ISBN: 978-3-319-42135-3
eBook Packages: MedicineMedicine (R0)