Training programs for aspiring doctors have long been thought of as a trial by fire. Long hours, exacting standards and the typically large number of high-stakes decisions have long been considered as much of a standard part of becoming a doctor as medical school classes. Those who want to enter the profession have learned to expect running this gauntlet, but many don't anticipate that in addition to battling sleeplessness, fatigue and stress, they might also be forced to survive unrelenting harassment and intimidation not only from their supervisors, but from their peers, too.
The problem of workplace harassment of medical students was first studied more than 30 years ago by a doctor who specialized in treating abused children. Several subsequent studies found that students faced the most harassment during their third year of medical school, when, for the first time, they left the classroom environment and started working in the field overseen by senior physicians and residents. Then, nearly 85% of students surveyed felt that they had been victims of abuse that ranged from being yelled at and insulted in front of supervisors and peers, to threats of bad grades and ruined careers. Some even reported incidents of physical assault including pushing, hitting and having medical implements and other objects thrown at them.
Nonetheless, many of these researchers believed that such mistreatment could be eliminated, or at least significantly mitigated, if each medical school acknowledged the behavior, then created institutional anti-harassment policies, grievance committees and educational, training and counseling programs to break the abuse cycle.
At least one medical school took the problem seriously. Starting in 1995, the leaders of the David Geffen School of Medicine at the University of California Los Angeles implemented a number of school-wide reforms aimed at reducing the problem of harassment and abuse. Changes included the establishment of the Gender and Power Abuse Committee, required anti-harassment lectures, and workshops on how to deal with and prevent incidents not only for students, but also for faculty and residents. Those who were victims had a way to file complaints anonymously to minimize the possibility of retaliation.
To track how effective the measures were, the school asked all third-year students to fill out a questionnaire on their experience in during the previous year.
The school has just published the sobering results of the surveys over the last 13 years. While there appears to have been a slight drop in the numbers of students who report experiencing mistreatment, more than half of all medical students still said that they had been intimidated or physically or verbally harassed.
Joyce M. Fried, the author of the paper and the head of the Gender and Power Abuse Committee, said she was "crushed" when she saw the results. When the reforms were being put in place more than a decade ago, Fried didn't anticipate the difficulties they'd encounter rooting out harassment from its school and teaching hospital.
"There are a lot of really good people and role models out there," Ms. Fried said. "But the culture for all these years has been to just take the mistreatment and not say anything."
"It wasn't right back then, and it shouldn't be tolerated anymore," she added.