Our stereotypical image of a bully is that of a physically imposing, football-playing jock who is about to shove a “nerd” into a locker. The victims of bullying describe years of torment and in the most unfortunate cases, some victims have committed suicide. More recently, the new “locker” has become facebook and twitter where bullying has become rampant. Appropriate uproar and activism against bullying has led to massive campaigns in elementary and high schools to stop it. None of the recent news stories, however, have describe a bully to be wearing a white coat and a stethoscope, employed in a role where they help people.
A recent article by Dr. Pauline Chen in the NY Times blog section has shed light on the continued culture of mistreatment that exists within our medical training system. In fact, the UCLA school of medicine has identified bullying/mistreatment as a significant problem within their institution and just released a study of their experience in trying to prevent it. What is absolutely shocking is that nearly 50% of respondents (from more than 2000 trainees) reported experiencing some type of mistreatment. And this proportion didn’t change even after they had implemented new policies and procedures to reduce its occurrence. But even more disturbing is that 5% (more than 100 trainees) reported physical mistreatment! I was shocked when I read this. Having been in the medical training system for the past 8 years of my life, I have thankfully never experienced this nor watched as others have. But clearly there’s a problem and it doesn’t appear to be isolated to UCLA as the American Medical Association has recognized this issue on a national level.
What is most concerning is that this bullying and mistreatment is coming from so-called “medical educators”. These medical schools and residency training programs are supposed to employ some of the best, most innovative and brightest minds in medicine. Medical educators can’t simply turn their backs on this issue. This can have potentially devastating consequences for trainees, staff and patients if it’s allowed to continue. What is frightening is that despite an institution wide attempt to reduce bullying, UCLA demonstrated minimal success. As the authors of the study concluded “eliminating mistreatment requires an aggressive approach both locally at the institution level and nationally across institutions”.