A Study Exposes a Frightening Truth About American Medical Schools
Harassment is common, and directed at the most vulnerable students.
Close your eyes for a second and think about medical school. The popular conception of medical school is one of a grueling, but ultimately rewarding experience. Long hours in the library, punctuated by moments of excitement as hard-fought knowledge is finally applied to a real human.
For me, medical school was an exhilarating, if challenging, time. I was learning what I thought were the deepest secrets of the human body. I interacted with individuals at their most vulnerable moments and felt like I made a difference. And of course, I worked my ass off. That’s ok — no one ever said med school was supposed to be easy.
But for too many med students, med school is not simply a tough but rewarding four years, it is a gauntlet — an environment where around any corner there might be someone who will demean, belittle, or harass you. And, according to this study in JAMA Internal Medicine, the individuals running that gauntlet are disproportionately women, racial, ethnic, and sexual minorities.
Prior studies have looked at harassment of medical students, but this one really brings the numbers.
27,504 student surveys, taken at med school graduation over a two-year period were included in the analysis. The surveys asked a host of questions about the medical school experience, but importantly included questions like “how frequently were you publicly humiliated?” and “been subject to sexist remarks or names” and “been denied opportunities for training based on race/ ethnicity”.
I was shocked when I saw the results. Please check out the paper because I can only highlight a few standouts here, but for example:
A quarter of male, and 40% of female graduates reported experiencing mistreatment. Nearly a quarter of female graduates reported they were subject to sexist remarks or names. 7% to unwanted sexual advances. Roughly 20% of male and female graduates were publicly humiliated.
Under-represented minorities bore the brunt of mistreatment, with around a quarter having experienced race or ethnicity-based discrimination, and a fifth subjected to racially offensive remarks or names.
Sexual minorities also appeared to be targeted, with 23% reporting discrimination based on sexual orientation, and 27% publicly humiliated.
And these experiences were synergistic. Under-represented minority women, for example, were more likely to be harassed and discriminated against than white women or under-represented minority men.
This is, obviously, unacceptable. What I worry about is that some physicians won’t see it that way. I am fully aware that med school has a bit of a hostile culture. All docs remember being “pimped” on rounds: put on the spot and asked to demonstrate our knowledge amidst a group of senior physicians.
I have issues with that modality of teaching, but I want to be clear that this is NOT solely what this study is talking about.
The thing that bothers me most in this space are those physicians who seem to think the hostile culture of medical school is a feature not a bug. That somehow we need it to make good doctors. I think this is not only wrong but about 180 degrees wrong. I think this culture makes worse doctors. But if we continue to allow that hostility, and allow it to be directed to physicians-in-training who actually reflect the diversity of our patient population — if we disrespect those students — the profession will lose the respect from society that we’ve enjoyed for so long.
A version of this commentary first appeared on medscape.com.