As with most fraternities, clubs, teams in the U.S. and likely world
wide, hazing appears to be the norm. Just as the "pack leader"
threatens and intimidates the young to teach them, mankind reverts to
the same methodology - instead of encouragement, punishment. It
permeates our society. The worst aspect showing up in our prison system.
Perhaps our age of enlightenment has been nothing but fog.
D.
On 12/08/2012 10:39 AM, Arthur Cordell wrote:
*Subject:*The Bullying Culture of Medical School
The Bullying Culture of Medical School
* /by/ PAULINE W. CHEN, M.D.
* Aug. 9, 2012 NY Times
*
Powerfully built and with the face of a boxer, he cast a bone-chilling
shadow wherever he went in the hospital.
At least that is what my medical school classmates and I thought
whenever we passed by a certain resident, or doctor-in-training, just
a few years older than we were.
Dr. Pauline Chen on medical care.
With the wisdom of hindsight, I now see that the young man was a
brilliant and promising young doctor who took his patients' conditions
to heart but who also possessed a temper so explosive that medical
students dreaded working with him. He had called various classmates
"stupid" and "useless" and could erupt with little warning in the
middle of hospital halls. Like frightened little mice, we endured the
treatment as an inevitable part of medical training, fearful that
doing otherwise could result in a career-destroying evaluation or grade.
But one day, one of our classmates, having already been on the
receiving end of several of this doctor's tirades, shouted back. She
questioned one of his conclusions in front of the rest of the medical
team, insisted on getting an explanation, then screamed back when he
started yelling at her.
The entire episode unnerved us all; and over the next few weeks, we
marveled at her courage and fretted over her potentially ruined career
prospects. But there was one aspect of the event that disturbed us
even more. One classmate who had witnessed the "screaming match"
described how our fellow medical student had raised her voice and
positioned her body as she threatened the doctor. "It was weird," he
recounted. "It was like watching her turn into him."
For 30 years, medical educators have known that becoming a doctor
requires more than an endless array of standardized exams, long hours
on the wards and years spent in training. For many medical students,
verbal and physical harassment and intimidation are part of the
exhausting process, too.
It was a pediatrician
<http://jama.jamanetwork.com/article.aspx?articleid=380396>, a pioneer
in work with abused children <http://www.pahx.org/silver-henry->, who
first noted the problem. And early studies found that abuse of medical
students
<http://www.nytimes.com/1990/01/26/us/wide-abuse-of-medical-students-found.html>
was most pronounced in the third year of medical school
<http://jama.jamanetwork.com/article.aspx?articleid=380396>, when
students began working one on one or in small teams with senior
physicians and residents in the hospital. *The first surveys found
<http://jama.jamanetwork.com/article.aspx?articleid=380398> that as
many as 85 percent of students felt they had been abused during their
third year. They described mistreatment that ranged from being yelled
at and told they were "worthless" or "the stupidest medical student,"
to being threatened with bad grades or a ruined career and even
getting hit, pushed or made the target of a thrown medical tool.*
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.
One medical school became a leader in adopting such changes. Starting
in 1995,
<http://journals.lww.com/academicmedicine/Abstract/publishahead/Eradicating_Medical_Student_Mistreatment___A.99583.aspx>
educators at the David Geffen School of Medicine at the University of
California, Los Angeles, began instituting a series of schoolwide
reforms. They adopted policies to reduce abuse and promote prevention;
established a Gender and Power Abuse Committee, mandated lectures,
workshops and training sessions for students, residents and faculty
members; and created an office to accept confidential reports,
investigate and then address allegations of mistreatment.
To gauge the effectiveness of these initiatives, the school also began
asking all students at the end of their third year to complete a
five-question survey on whether they felt they had been mistreated
over the course of the year.
The school has just published the sobering results
<http://journals.lww.com/academicmedicine/Abstract/publishahead/Eradicating_Medical_Student_Mistreatment___A.99583.aspx>
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.
*Students described being yelled at, pushed and threatened. One
student recounted being slapped on the hand by a more senior doctor
who said, "If teaching doesn't help you learn, then pain will." Some
students wrote about racial insults, with senior staff members making
noises to mimic a foreign language; others reported being grabbed,
asked out on a date or passed over because of their sex.*
"We were really crushed when we saw the results," said Joyce M. Fried,
lead author of the paper and assistant dean and chairwoman of the
Gender and Power Abuse Committee at the medical school. "We were
disappointed that it was so difficult to change."
*U.C.L.A.'s experience is not isolated. In fact, national medical
education surveys
<http://www.ama-assn.org/resources/doc/medical-schools/sms-a11-mistreatment.pdf>
that include questions about mistreatment indicate that the
environment at that school is about average. And the striking
similarity of experiences across a generation of students suggests
problems not just with one institution, but with the culture of
medical training itself. "This is a national problem," Ms. Fried said.
"Our faculty and doctors-in-training come from all over, including
schools where some of them might have been mistreated."*
While their findings are disheartening, Ms. Fried and her colleagues
continue to believe that medical student mistreatment can be
significantly reduced --- but only if all medical schools come
together to work on the issue. "We're talking about the really hard
task of changing a culture, and that has to be done on a national
level," Ms. Fried said. Such an effort would include shared training
programs, common policies regarding mistreatment and greater
transparency about the mistreatment that currently exists in medical
schools.
"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.
_______________________________________________
Futurework mailing list
[email protected]
https://lists.uwaterloo.ca/mailman/listinfo/futurework
_______________________________________________
Futurework mailing list
[email protected]
https://lists.uwaterloo.ca/mailman/listinfo/futurework
