Bullying is still a problem for medical residents, according to new research.
Some 14% of internal medicine physicians said they were bullied by superiors during their residency training, according to a research letter published in JAMA.
It’s a problem residency programs need to address said the researchers, who surveyed over 21,000 residents who took the 2016 Internal Medicine In-Training Examination, a self-assessment administered by the American College of Physicians.
“Taking steps to eliminate bullying is essential to ensure supportive learning environments that will promote the professional development of all medical trainees,” the authors wrote.
The bullying took various forms, but the most common type was verbal harassment (80%). However, harassment was also physical (5.3%) and sexual (3.6%). Twenty-five percent of respondents who had been bullied reported “other” forms of harassment.
A small number (2%), said the bullying led to their leaving the residency program. On the other hand, 6% reported improved performance.
The issue of workplace bullying has been one that the healthcare industry and training programs have been challenged to address. In particular, sexual harassment in the medical field has drawn more attention as a result of the #MeToo movement.
In previous studies, the rates in which medical trainees reported bullying fluctuated between 10% to 48%, differing by the level of training and the country. However, a resident study of internal medicine residency training program directors found that only 31% were aware of any bullying of their residents during the previous year.
A supplement to the 2016 examination asked residents if they were ever bullied during their time at their residency program. The survey defined bullying as “harassment that occurs repeatedly by an individual in a position of greater power.”
Only 31% of those who felt bullied sought help to deal with the problem. The most common consequences of bullying were burnout (57%), worsened performance as a resident (39%), and depression (27%).
Certain residents were more likely to report bullying, including those who speak a native language other than English, higher postgraduate year level, being an international medical graduate and lower performance on the examination. Compared with U.S. residency programs, trainees at international residency programs had significantly greater odds of experiencing bullying, the survey found.
The researchers said bullying was most likely underestimated because the survey did not include questions about “less consequential hassling” by superiors and harassment by those of equal or less power.