Cause and Affect – ctd.

I’ve written previously about how I feel like residency can often dampen empathy. But that’s after graduation. Medical school is no picnic either. I remember that we used to joke that if someone didn’t make you cry on your surgery rotation, then you must be doing something wrong.

As I get older, that seems less and less funny. Then I saw this. “Medical students still suffer mistreatment by faculty, resident doctors, and nurses, US report says“:

More than half of medical students reported some mistreatment during their third year, when they began clinical clerkships and to work with residents, attending physicians, medical school faculty, nurses, and patients, and family members, found the study, published in Academic Medicine, the journal of the Association of American Medical Colleges.

Categories of mistreatment included physical, verbal, and sexual harassment and ethnic and power abuse problems, which were categorized as mild, moderate, and severe.

This piece reports on efforts at the David Geffen School of Medicine of the University of California, Los Angeles to curb mistreatment:
The study reviewed medical students’ reports of mistreatment during four periods: 1996-8 (before the implementation of interventions); 1999-2000 (the two years immediately after reporting initiatives were introduced); 2001-5 (during which the school’s gender and power abuse committee established a formal reporting and investigation system); and 2006-8 (the period after the California legislature required all state employed supervisors, including university faculty and staff, to complete a two hour online sexual harassment training course every two years and during which the medical school introduced a session on mistreatment for students).
The surveys had a response rate of more than 90%, which is just insanely high. Here’s the depressing bit: More than half of medical students reported mistreatment. Most of it was verbal or power related, but 5% was physical. That’s horrifying. Women were more likely to be mistreated than men. Few students reported it or looked for assistance.

The levels and types of mistreatment didn’t change in any of the study periods. In other words, the efforts to make things better didn’t seem to work.

According to the story, when the doctors were notified of these results, they were shocked. I don’t know why. I remember medical school. I saw some terrible behavior then, and I still hear about some now.

People wonder why doctors can sometimes seem uncaring or disconnected. They sometimes blame it on the constant exposure to pain or suffering. But I think we, as a profession, are somewhat to blame for fostering an atmosphere we would find repugnant in any other setting. I’ve written about it before. Perhaps it’s time we remember that our trainees are people too, and just as worthy of respect and empathy as patients.



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