Medical school can be emotionally and physically dangerous for women and minorities, study finds
40.9% of female students reported at least one episode of mistreatment, compared to 25.2% of male students.
Mistreatment of medical students continues to be a serious problem at many medical schools around the country, especially for women, minorities, or those who are LGBTQ, a study by researchers at Yale School of Medicine has found.
Mistreatment includes discrimination, assault, verbal abuse, and sexual harassment. Previous research has linked mistreatment to burnout and depression, serious mental-health issues that can affect a doctor’s ability to deliver high-quality care to patients.
Researchers analyzed data collected by the Association of American Medical Colleges Graduate Questionnaire from 27,504 students at 140 U.S. medical schools in 2016 and 2017. The study was published in the journal JAMA Internal Medicine.
Nearly 41% of female students reported at least one episode of mistreatment, compared with 25.2% of male students. Women reported a higher prevalence of unwanted sexual advances, being denied opportunities for training or rewards based on gender, being subjected to sexist remarks or names, and receiving lower evaluations or grades for the same work.
“There are probably a number of reasons contributing to why this has not gone away yet,” said lead author Katherine Hill, a second-year medical student at the Yale School of Medicine. “Part of it might be that we have to do a better job promoting the idea that mistreatment is not acceptable, that we value inclusion, diversity, and student safety. There needs to be more of a focus from medical schools and teaching hospitals going forward.”
The survey also found that students who identified as Asian, black, Latino, Native American, or multiracial, or lesbian, gay, or bisexual experienced more discrimination than students who identified as white or straight. Women of color reported the highest prevalence of racial discrimination.
“Women and minorities are already underrepresented in the medical profession,” Hill said. “These missed opportunities from mistreatment can accumulate over a lifetime and contribute to keeping those people out of the medical field.”
The most commonly reported type of mistreatment was public humiliation, when someone, often a resident or attending physician, intentionally embarrasses a medical student.
Previous studies show that medical students who experience mistreatment and discrimination have worse mental and physical health. They are also more likely to consider dropping out of medical school due to decreased self-confidence and self-esteem.
Historically, gathering data on the prevalence of medical student mistreatment has been challenging. A 2018 study at the Geffen School of Medicine at UCLA found that the number of students who experience mistreatment is much higher than the number of students who report it. Often, students refrain from reporting abusive behaviors because they are afraid of retaliation, even in anonymous settings, as well as a perception that the medical culture includes mistreatment.
“I would suspect that a significant proportion of the people who said they were mistreated in our study did not report the incidents" to medical school officials, Hill said.
“Unfortunately, right now we don’t have a lot of evidence-based solutions for reducing mistreatment,” Hill said. “But accrediting bodies should start to focus on encouraging diversity in medical education. Up until this point, the focus has been on overall numbers and recruiting students, when it should also be on creating a climate of equity and inclusion for those who do enter the field.”