Learning About Medical Student Mistreatment From Responses to the Medical School Graduation Questionnaire

Abstract

Although evidence of medical student mistreatment has accumulated for more than 20 years, only recently have professional organizations like the Association of American Medical Colleges (AAMC) and the American Medical Association truly acknowledged it as an issue. Since 1991, the AAMC's annual Medical School Graduation Questionnaire (GQ) has included questions about mistreatment. Responses to the GQ have become the major source of evidence of the prevalence and types of mistreatment. This article reviews national mistreatment data, using responses to the GQ from 2000 through 2012; examines how students' experiences have changed over time; and highlights the implications of this information for the broader medical education system. The authors discuss what mistreatment is, including the changing definitions from the GQ; the prevalence, types, and sources of mistreatment; and evidence of students reporting incidents. In addition, they discuss next steps, including better defining mistreatment, specifically public humiliation and belittling, taking into account students' subjective evaluations; understanding and addressing the influence of institutional culture and what institutions can learn from current approaches at other institutions; and developing better systems to report and respond to reports of mistreatment. They conclude with a discussion of how mistreatment currently is conceptualized within the medical education system and the implications of that conceptualization for eradicating mistreatment in the future.

Exploring medical students’ barriers to reporting mistreatment during clerkships: a qualitative study

“…Mistreatment can have deleterious effects on medical students’ emotional well-being and professional attitudes [1,2]. Specifically, medical students who are subject to abusive behaviors are more likely to experience mental health issues such as post-traumatic stress [3,4], depression and low career satisfaction [5], and even suicidality [6].…”

“…Specifically, medical students who are subject to abusive behaviors are more likely to experience mental health issues such as post-traumatic stress [3,4], depression and low career satisfaction [5], and even suicidality [6]. More than three decades of studies have shown that the behavior of faculty, residents, and nurses toward medical students can be unprofessional and abusive, particularly during clinical clerkship rotations [1,5,7,8]. A meta-analysis demonstrated a high prevalence of harassment and discrimination toward medical trainees worldwide, with 59% of medical trainees experiencing at least one form of harassment or discrimination during their training [8].…”

Measuring Mistreatment: Honing Questions about Abuse on the Association of American Medical Colleges Graduation Questionnaire

“…Since 2000, 13 to 20 percent of graduating medical students report that they have been mistreated, with clinical settings the mostly likely place for these incidents [4]. When medical schools are compared, the proportion of graduates reporting mistreatment varies widely from approximately 5 to 40 percent, but averaging 17 percent [5]. subjective experience in determining whether or not mistreatment has occurred.…”

Health professionalism must be ensured online and offline

“…2 More troubling, national surveys of US medical graduates between 2000 and 2011 found that 25% reported mistreatment that included sexist names or remarks and that 13% had experienced unwanted sexual advances, some involving medical colleagues or supervisors. 3 There exists a wider societal problem of gender-based violence and victimization. Statistics Canada documented 21 300 reported assaults in Canada in 2013.…”