Study: More than one-third of medical students experience mistreatment

More than one-third of medical students have reported experiencing at least one incident of mistreatment by faculty, peers, or clinical staff, according to a new study appearing in JAMA Internal Medicine.

The study looked at responses from 27,504 responses to the 2016 and 2017 Association of American Medical Colleges Graduation Questionnaire and found that 35.4 percent of respondents reported experiencing at least one form of mistreatment. The top form of mistreatment was public humiliation with 21.1 percent of respondents reporting they experienced it.

The study also found that female, Asian, underrepresented minority, multiracial, lesbian, gay, and bisexual students all reported more incidents of mistreatment than their white, male, heterosexual peers.

Unsurprisingly, female students reported a greater amount of discrimination based on gender, while Asian, underrepresented minority, and multiracial students experience more based on their race or ethnicity than their white peers, and lesbian, gay, and bisexual students saw more discrimination based on sexual orientation, the study says.

The authors of the study write that the results can be indicative of the students being taught in a “non-inclusive learning environment,” and connected the research to prior studies which have found an association between mistreatment and discrimination with student reports of decreased physical and mental health, worsening grades, lower academic motivation, and persistence.

An editor’s note tied to the study says it stands as a reminder of the need to improve the learning climate in medical education. It suggest that action should be taken both institutionally and as individuals. It calls for attending physicians to act as “first responders” when microaggressions or offensive statements occur, supervisors should not mistake a student’s response to mistreatment as disinterest or lack of knowledge, and educators need to give useful and constructive feedback to underrepresented students while being mindful of implicit bias.

Institutions should develop a system for confidentially reporting mistreatment, while also training faculty to identify and respond to discriminatory microaggressions, according to the editor’s note.

“Although the culture of diversity and inclusion in medicine has progressed by leaps and bounds over the past few decades, there remain large gaps and challenges for true inclusiveness that goes beyond numbers,” the editor’s note says. “We should aspire to a higher standard, where all educators are trusted by students to take the lead in naming and responding to instances of mis- treatment in clinical settings.”