Family medicine graduates' perceptions of intimidation, harassment, and discrimination during residency training

Abstract

BackgroundDespite there being considerable literature documenting learner distress and perceptions of mistreatment in medical education settings, these concerns have not been explored in-depth in Canadian family medicine residency programs. The purpose of the study was to examine intimidation, harassment and/or discrimination (IHD) as reported by Alberta family medicine graduates during their two-year residency program.MethodsA retrospective questionnaire survey was conducted of all (n = 377) family medicine graduates from the University of Alberta and University of Calgary who completed residency training during 2001-2005. The frequency, type, source, and perceived basis of IHD were examined by gender, age, and Canadian vs international medical graduate. Descriptive data analysis (frequency, crosstabs), Chi-square, Fisher's Exact test, analysis of variance, and logistic regression were used as appropriate.ResultsOf 377 graduates, 242 (64.2%) responded to the survey, with 44.7% reporting they had experienced IHD while a resident. The most frequent type of IHD experienced was in the form of inappropriate verbal comments (94.3%), followed by work as punishment (27.6%). The main sources of IHD were specialist physicians (77.1%), hospital nurses (54.3%), specialty residents (45.7%), and patients (35.2%). The primary basis for IHD was perceived to be gender (26.7%), followed by ethnicity (16.2%), and culture (9.5%). A significantly greater proportion of males (38.6%) than females (20.0%) experienced IHD in the form of work as punishment. While a similar proportion of Canadian (46.1%) and international medical graduates (IMGs) (41.0%) experienced IHD, a significantly greater proportion of IMGs perceived ethnicity, culture, or language to be the basis of IHD.ConclusionsPerceptions of IHD are prevalent among family medicine graduates. Residency programs should explicitly recognize and robustly address all IHD concerns.

Approaches for Residents to Address Problematic Patient Behavior: Before, During, and After the Clinical Encounter

“…Historically, medical training has promoted a culture of silence and submission-suggesting that, somehow, experiencing inappropriate behavior is a rite of passage. 2 Problematic patient behavior contributes to physician burnout, poor work performance, and avoidance of specific patients. 3,4 Medical education in the United States has not adequately addressed this problem.…”

Sticks and stones: investigating rude, dismissive and aggressive communication between doctors

“…11 RDA communication is distinct from bullying which is a more persistent and powerbased form of abuse most commonly occurring within a department. 2,12 Doctors who are recipients of bullying and negative communication have increased levels of stress and depression, and an increased desire to leave medicine. 9 There is increasing recognition that this kind of adverse staff interaction leads to worse patient outcomes and can represent a patient safety threat.…”

Ebola, Team Communication, and Shame: But Shame on Whom?

“…Health professionals also report being bullied by each other. Residents and medical students report being routinely harassed by nurses during their training years, sometimes in cruel and demeaning ways (Crutcher et al 2011;Fnais et al 2014;Schlitzkus et al 2014). Nurses report experiencing incivility from physicians (Brewer et al 2013;Laschinger 2014;Tang et al 2013).…”