Medical Student Abuse

As I noted in a previous posting, there currently is a problem in the education of medical students about professional behavior including humanism. They may be given explicit information during their first two years of medical school but by the 3rd year and beyond this information may be degraded by their tacit learning attending to patients under supervision of their superiors. They may “learn” wrongs from their superior’s misbehavior and yet many students may find it impossible to avoid this in view of the pressures, self-interest and abuse they will encounter. Yes, I wrote abuse. You have heard of child abuse, elder abuse, spousal abuse and abuse on the job.. well, there is also medical student abuse which has been going on for years and years. Many older physicians have never looked at this behavior as abuse but only part of the initiation ritual which they themselves had to survive during their formative years.

From the American Medical Association News in 2000:

Mistreatment of medical students appears to have declined during the past six years, according to surveys of fourth-year students by the Assn. of American Medical Colleges.

But medical education experts believe statistics are misleading and that students continue to be subject to unacceptable levels of public belittlement, humiliation, and physical and sexual abuse, and have been denied opportunities for advancement because of gender or ethnicity.

"If you think abuse is gone, it is not," said Harry Jonas, MD, co-secretary of the Liaison Committee on Medical Education. LCME accredits the nation's 125 medical schools.

In a survey of 12,734 seniors conducted last year, the AAMC found that 26.7% had been occasionally belittled or humiliated compared with 28.1% in 1998. Slightly more than half, 51.1%, said they had never been subject to such abuse during their four years compared with 48.1% in 1998 and 61.7% in 1996.

As in past surveys, women and minority students recorded more incidents of sexual, physical and mental abuse than white men, the AAMC survey found.

As you can see from the above statistics, whether the situation is improving or not, the percentages are still large and may be incomplete. Ritual or not, either is destructive toward instilling the professional behavior we all would like to see in our physicians. ..Maurice.