The Bullying Culture of Medical School - NYTimes.com

[IJL]

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As I said, my program is pretty benign.

Once on GYN, I saw one of my post-op patients and on my exam I noticed a 3/6 systolic murmur. I asked her if she was aware of it. She wasn't, and she got pretty worried. I told her that most murmurs are benign, and that post-surgical murmurs were common, but that I would check with my boss to see if he felt like it needed further attention (also she was asymptomatic).

When I went to talk with my resident he immediately asked me why I had told her about the murmur and started bitching me out, saying that "now we may have to do something" and that "this isn't cardiology". Later in clinic, I was told by 2 different residents, out of the blue, to just go in and do a physical, and to not try and "counsel the patient". Their tone and choice of words led me to suspect that the first resident had been talking **** behind my back.

I documented everything that had been said, and knowing that the clerkship director was very reasonable, I went to her with my concerns. Later, when I got a negative evaluation from this particular resident, I cited what had happened and the eval was not factored into my grade and I found out later that the resident was told to stop being such a dick.

Anyway, not sure if it counts as bullying, but it was an unpleasant encounter that resolved rather well.

Sounds like the resident was right... You should never tell the patient something like that without talking up your resident first.

 

[deleted103644]

Sounds like the resident was right... You should never tell the patient something like that without talking up your resident first.

Seriously?

Observing a murmur and asking a patient if anyone had ever told her about a murmur before is H&P 101.

Unless you have auditory hallucinations or are completely inept at a physical, asking a pt if anyone has ever told them they have a murmur as an MS is completely fine as long as you say that you need to confirm with a senior and make sure you do not alarm the pt.

 

[strongboy2005]

Sounds like the resident was right... You should never tell the patient something like that without talking up your resident first.

If I hear a heart murmur, I ALWAYS ask the patient if they have been diagnosed with one before. This is a standard question.

 

[deleted103644]

If I hear a heart murmur, I ALWAYS ask the patient if they have been diagnosed with one before. This is a standard question.

Seriously.

 

[Rollo]

Sounds like the resident was right... You should never tell the patient something like that without talking up your resident first.

No, that resident was just lazy and didn't want to work up the patient for a murmur which most likely consisted of a) getting an in-house cardio eval or b) referring as outpt to cardio. Sure, doing a might have held up patient's discharge that day but you know what, that patient could always be transferred to medicine if there are no more surgical issues.

 

[Mass Effect]

I'm sorry, but the people talking about reporting abuse and standing up for yourself as if it's an easy thing don't know what they are talking about. Having run into abuse myself, I was frankly told that as a student I had no leverage and that being right was not leverage. Students that piss off the wrong person can be subject to swift and extreme retribution, and they actually have very little protection.

Don't assume that your experience is universal and those of us who disagree don't know what we're talking about. There are posters on this thread who've experienced it first-hand and their experience is different from yours.

Suppose an attending sees you and hates you because of your race/ethnicity/whatever. Then he writes you a terrible evaluation ("this student has poor bedside manner, was frequently late, seemed disinterested, uncomfortable with basic procedures, etc"). Suppose you even fail the clerkship. What is your recourse?

Assuming this is a hypothetical, what's the basis of thinking he hates you because of race/ethnicity/whatever? Has this been made obvious by his treatment of you? If so, then this is why you report these things as they happen, so that you're not waiting until after a bad evaluation to complain.

 

[Bigz]

I think we must require medical students to get real life experiences before medical school if many hold the view that they are powerless. Having worked in a corporate environmental I cannot imagine taking any ovrert abuse or bullying from anybody. Now we must also realize that criticism and even harsh criticism is not bullying.

 

[Rollo]

I think we must require medical students to get real life experiences before medical school if many hold the view that they are powerless. Having worked in a corporate environmental I cannot imagine taking any ovrert abuse or bullying from anybody. Now we must also realize that criticism and even harsh criticism is not bullying.

Bingo.

I think most medical students who feel they were bullied conclude that that is what happened after receiving harsh criticism.

How many times have we all heard about a student complaining how a certain resident or attending is an a-hole and turns out that the resident or the attending is just tough on students and likes to ask tough questions?

 

[KnuxNole]

No, that resident was just lazy and didn't want to work up the patient for a murmur which most likely consisted of a) getting an in-house cardio eval or b) referring as outpt to cardio. Sure, doing a might have held up patient's discharge that day but you know what, that patient could always be transferred to medicine if there are no more surgical issues.

Agreed, usually the residents who barely passed Step 1/2 or who went to med school without having to do any H+Ps 😛

 

[deleted103644]

Agreed, usually the residents who barely passed Step 1/2 or who went to med school without having to do any H+Ps 😛

Also, it always looks bad when a patient develops a "new" murmur after several "thorough" evaluations by the resident.

 

[hughnguyen22]

If I do something wrong, I am up for critique. I do not mind being called names. However, someone's putting their hands or throwing things at me is a different story. I will:
1. Punch back
2. Catch whatever they throw and throw it back at them.
3. Then file a lawsuit.
Voila, there solves the bullying issue.

 

[Mass Effect]

I think we must require medical students to get real life experiences before medical school if many hold the view that they are powerless. Having worked in a corporate environmental I cannot imagine taking any ovrert abuse or bullying from anybody. Now we must also realize that criticism and even harsh criticism is not bullying.

Excellent post!

 

[Abby_Normal]

I think in any situation in which you are likely to encounter difficult people, you want to identify and then build a rapport with one of the reasonable/approachable people as soon as possible. They can be your best resource.

 

[VenusinFurs]

Sounds like the resident was right... You should never tell the patient something like that without talking up your resident first.

Yeah, no.

 

[JPSmyth]

so hypothetically, what would the resident be able to do if you talk back? can they really fail you? because I am not one to take **** from anybody. verbal disrespect I could take for a while, but if it ever became physical there would be problems. do you think that physical threats are more prevalent for
stereotypical small scrawny students? I honestly can't foresee a resident making threats to me, I feel like being big would deter this from happening.

 

[seelee]

so hypothetically, what would the resident be able to do if you talk back? can they really fail you? because I am not one to take **** from anybody. verbal disrespect I could take for a while, but if it ever became physical there would be problems. do you think that physical threats are more prevalent for
stereotypical small scrawny students? I honestly can't foresee a resident making threats to me, I feel like being big would deter this from happening.

First, I have never ever seen any resident or attending physically threaten or physically abuse a medical student. The "abuse" I have seen is much more subtle and under the radar. Yelling, berating a resident in front of others, calling them "useless", "horrible", etc. Most people I know wouldn't even think of this as being "abuse".

Second, regarding the consequences of talking back, it depends on the resident, and the program.

Standing up for yourself may get the abuser to rethink his words/actions. Most likely they will get butthurt and your evaluation will suffer.

If you have a program that is hypervigilent against bullying and abuse, then you might get some recourse from them.

My opinion is that if you are physically threatened (i.e. someone threatens or actually hits you) then you report it. If the person is just an *******, you let it role off your back and give him a negative eval at the end of the rotation.

 

[Mattchiavelli]

As I said, my program is pretty benign.

Once on GYN, I saw one of my post-op patients and on my exam I noticed a 3/6 systolic murmur. I asked her if she was aware of it. She wasn't, and she got pretty worried. I told her that most murmurs are benign, and that post-surgical murmurs were common, but that I would check with my boss to see if he felt like it needed further attention (also she was asymptomatic).

When I went to talk with my resident he immediately asked me why I had told her about the murmur and started bitching me out, saying that "now we may have to do something" and that "this isn't cardiology". Later in clinic, I was told by 2 different residents, out of the blue, to just go in and do a physical, and to not try and "counsel the patient". Their tone and choice of words led me to suspect that the first resident had been talking **** behind my back.

I documented everything that had been said, and knowing that the clerkship director was very reasonable, I went to her with my concerns. Later, when I got a negative evaluation from this particular resident, I cited what had happened and the eval was not factored into my grade and I found out later that the resident was told to stop being such a dick.

Anyway, not sure if it counts as bullying, but it was an unpleasant encounter that resolved rather well.

Basically your resident was being lazy, you did the right thing. If the murmur had been something real and the patient had a bad outcome related to it, they could go back in the chart and see your lazy resident had probably documented "no MRG" on CV exam and she would be pissed at you that you weren't saving her ass. Let her deal with it. Some people practicing medicien really need to grow up

Anyway if anyone is facing actual sexual harrassment/physical abuse, if you don't think your school will do anything or won't do anything take it to risk management at the hospital where it happened and see how quickly **** goes into motion

 

[Miss Alyssa]

A typical 3rd year medical student is an adult. As an adult, you need to learn to stand up for yourself and call a spade a spade.

My rotations have been mostly benign but I have been able to put a stop to any potential for verbal abuse when I suspect that a particular resident or attending is up to something. Now, it may help being a tall, fit male (I can "literally" stand up to most people and look them into eye to eye) so I'm not sure if it will work for everyone.

There is no reason for anyone to talk down to you or call you names or intimidate you no matter how old or experienced they are. And there is no reason for you to NOT stand up when these things happen. I can't remember the last time somebody's career was ruined in medicine simply because they called out a malignant behavior when they saw one.

That was exactly my attitude when I was being bullied by my senior resident. He had a very quick temper and would readily berate people. The students that were on the team with him before me were scared of him and wouldnt go on the floor if he was there. He would verbally abuse the junior residents to the point of making one of them cry (yes, a male). After enduring him for a week and a half I stood up to him and called him out on it. I came to medical school to be trained to be a doctor. I´m not paying $40,000 a year in tuition to be bullied or ridiculed. He was not being paid to be cruel, but to teach. At my school we´re told to first talk to the person that´s causing the problem, then move up the chain. I spoke with him privately. I was surprised when he said that no one had ever complained to him. I thought he was lying, but after this thread and reading the article, maybe not. He spent the remainder of the 2.5 weeks not talking to me and largely ignoring me. I was grateful. I still honored the rotation.


That being said, when I was in highschool I had a parttime job and one of the managers was verbally abusive to me in front of customers, and physically abusive to some other employees. After one particular incident when he was yelling at me in front of customers, I turned and told him off, telling him about himself and his short comings. I was later fired. It was worth it. (I have better conflict resolution skills now, but I still stand up for myself)

 

[Rollo]

That was exactly my attitude when I was being bullied by my senior resident. He had a very quick temper and would readily berate people. The students that were on the team with him before me were scared of him and wouldnt go on the floor if he was there. He would verbally abuse the junior residents to the point of making one of them cry (yes, a male). After enduring him for a week and a half I stood up to him and called him out on it. I came to medical school to be trained to be a doctor. I´m not paying $40,000 a year in tuition to be bullied or ridiculed. He was not being paid to be cruel, but to teach. At my school we´re told to first talk to the person that´s causing the problem, then move up the chain. I spoke with him privately. I was surprised when he said that no one had ever complained to him. I thought he was lying, but after this thread and reading the article, maybe not. He spent the remainder of the 2.5 weeks not talking to me and largely ignoring me. I was grateful. I still honored the rotation.


That being said, when I was in highschool I had a parttime job and one of the managers was verbally abusive to me in front of customers, and physically abusive to some other employees. After one particular incident when he was yelling at me in front of customers, I turned and told him off, telling him about himself and his short comings. I was later fired. It was worth it. (I have better conflict resolution skills now, but I still stand up for myself)

Yep, classic reaction of a bully who gets his jollies off from berating others. If, in fact, this person was just going through some rough times and was taking it out on others, they would have been apologetic and friendly to you from there on out.

Think about it. We all have rough times and inadvertently take it out on others but then we feel guilty and apologize to the person or become approval-seeking of that individual we offended. That is simply human nature.

On the other hand, bullies don't feel this type of remorse because in their minds they did nothing wrong. By you standing up to them, you cease to become a source of amusement to them hence the cold shoulder. They have nothing to gain from interacting with you because they know that they can't intimidate you. These type of people have never learned to interact in a genuine friendly manner with their fellow humans.

I'm quite honestly surprised that there are personalities like this in medicine - a field that demands some iota of basic human compassion.

 

[NewYorkDoctors]

Welcome to reality.

Best thing to do is to play the game until you are an attending

 

[Catman21]

You guys signed up to become doctors, not babies. So much whining these days. "OMG, I worked 16 hours and 1 minute on call last night, I HAVE TO REPORT THIS!"

EDIT: I just read the article. It is not OK to be verbally or physically abused.

I lol'd 😆

 

[Oogieboogie]

I know this forum is dead, but I wanted to comment on this since I just received a phone call from a fellow nurse. She was talking to me about a new orientee that was being bullied. Poor thing. She's only 2 months out of nursing school, and the nurses have already seemed to collectively put her in the cross hairs to die.

It's just not right.

Regardless of whether or not you think we should just be silent, bow our heads, and make it through medical school.

It's not right. Medicine is tough, which is why it's more important than ever to build a culture of teamwork and compassion. Medical students who are too afraid to ask questions of an attending don't make for very good students. If you are too scared to ask, then how will you learn? Seriously.

I have been bullied in numerous fields. In research, in the hospital, in EMS. Yes you need a tough skin to deal with tough personalities, but that doesn't mean that anyone can treat you however they want. I think the best way to handle this is for students to stand up for each other.

 

[WilliamsEph]

Med school admissions committees need to do a better job of screening out these psychopaths. Being a good doctor is much more than just grades and MCAT scores. These people must be good actors during their med school interviews.

 

[Kaustikos]

Man,
You guys really don't know how to handle abuse, do you? Physical abuse? I'd take it outside when he's going to his car or in public. Or do something to his car like ****-water in his windshield fluids...he'd come in all pissed and I'd respond - "****ty day?" I don't tolerate abuse and I can tell when a line is crossed. Call me stupid? Fine, that's fair considering I'll **** up a lot next year. But go beyond that and you're asking for it. The only reason they have to be this verbally abusive is because they were bitched around by everyone or they have such insecurities they need to belittle someone below them to feel better/up their ego. Guess what? I know that. Get verbally abusive and I'll call you out on your tiny penis or insecurities. Mom didn't let you suck on her breasts? No, you were probably bullied in school and feel like you have the right to bully me.

At this point - I know med schools won't kick me out for that. This fear that they'll get screwed over is just ridiculous.

 

[hrandani]

Man,
You guys really don't know how to handle abuse, do you? Physical abuse? I'd take it outside when he's going to his car or in public. Or do something to his car like ****-water in his windshield fluids...he'd come in all pissed and I'd respond - "****ty day?" I don't tolerate abuse and I can tell when a line is crossed. Call me stupid? Fine, that's fair considering I'll **** up a lot next year. But go beyond that and you're asking for it. The only reason they have to be this verbally abusive is because they were bitched around by everyone or they have such insecurities they need to belittle someone below them to feel better/up their ego. Guess what? I know that. Get verbally abusive and I'll call you out on your tiny penis or insecurities. Mom didn't let you suck on her breasts? No, you were probably bullied in school and feel like you have the right to bully me.

At this point - I know med schools won't kick me out for that. This fear that they'll get screwed over is just ridiculous.

Future OB resident spotted!

 

[Anigma07]

Man,
You guys really don't know how to handle abuse, do you? Physical abuse? I'd take it outside when he's going to his car or in public. Or do something to his car like ****-water in his windshield fluids...he'd come in all pissed and I'd respond - "****ty day?" I don't tolerate abuse and I can tell when a line is crossed. Call me stupid? Fine, that's fair considering I'll **** up a lot next year. But go beyond that and you're asking for it. The only reason they have to be this verbally abusive is because they were bitched around by everyone or they have such insecurities they need to belittle someone below them to feel better/up their ego. Guess what? I know that. Get verbally abusive and I'll call you out on your tiny penis or insecurities. Mom didn't let you suck on her breasts? No, you were probably bullied in school and feel like you have the right to bully me.

At this point - I know med schools won't kick me out for that. This fear that they'll get screwed over is just ridiculous.

Yea, I'm sure... you sound like you've already been abused.

Just take yourself seriously and attendings/residents will also.

 

[deleted307836]

Med school admissions committees need to do a better job of screening out these psychopaths. Being a good doctor is much more than just grades and MCAT scores. These people must be good actors during their med school interviews.

How do you suppose admissions should be changed to screen these individuals out?

 

[deleted6669]

How do you suppose admissions should be changed to screen these individuals out?

if you post regularly on sdn and are an assclown you don't get in....🙂

 

[Kaustikos]

Yea, I'm sure... you sound like you've already been abused.

Just take yourself seriously and attendings/residents will also.

I have. My past job was brutal/stressful and I had to learn the pitfalls of not having a spine/dealing with it properly. I'm not saying be like that from the get-go; I'm saying it's helpful to realize that defending yourself/not tolerating this abuse will help you. It avoids the depression/anger/resentment you'll develop which might make you JUST like that. It shows you're not a kid who tolerates bullying. Yes, you don't know as much as they do, but that's why YOU'RE IN SCHOOL. 😛 I don't care if you think I'm an idiot...I'm learning. I'd rather be wrong now instead of when I'm a doctor.

 

[Kaustikos]

Med school admissions committees need to do a better job of screening out these psychopaths. Being a good doctor is much more than just grades and MCAT scores. These people must be good actors during their med school interviews.

It's not really something you can rule out. This is something that's developed through a cyclical process. Resident/attending bullies student - student develops anger/resentment and holds on to it - student is resident and wants to take out this issue on people lower than him because of how he is/was treated - and the cycle continues.

 

[Anigma07]

It's not really something you can rule out. This is something that's developed through a cyclical process. Resident/attending bullies student - student develops anger/resentment and holds on to it - student is resident and wants to take out this issue on people lower than him because of how he is/was treated - and the cycle continues.

Idk what things you're going through in the clinic but it sounds messed up. As long as you feel like you deserve to be there you're fine. The people that get put down are the people who put themselves down.

 

[ManBroDude]

Sometimes you can't help getting bullied, ie: you remind them of their ex or someone that they hate, etc.

 

[Kaustikos]

Sometimes you can't help getting bullied, ie: you remind them of their ex or someone that they hate, etc.

See, that's my problem and I don't stand for it. I've had encounters where my direct supervisor tried to bitch me out because I was doing multiple tasks for other scientists. He complained that it left him with less time to work with me when he needed me. He just yelled at me for 15 minutes in front of my colleagues. I didn't change my expression the whole time and just excused myself. I went to talk to our boss and just directly asked him

"Am I spreading myself too thin?"

And he basically explained how my supervisor was being stressed because of the work load that was required of him and how he didn't know if he could keep up with it. I simply replied that the only reason I was working other tasks was because he never said he needed my help until it blew up in his face. He talked to the supervisor and that was the end of it. So, med school won't be like that, but I'll definitely reserve my right to not put up with it if I'm not in the wrong or if he's got some pent up frustration with his own issues.

 

[Anigma07]

See, that's my problem and I don't stand for it. I've had encounters where my direct supervisor tried to bitch me out because I was doing multiple tasks for other scientists. He complained that it left him with less time to work with me when he needed me. He just yelled at me for 15 minutes in front of my colleagues. I didn't change my expression the whole time and just excused myself. I went to talk to our boss and just directly asked him

"Am I spreading myself too thin?"

And he basically explained how my supervisor was being stressed because of the work load that was required of him and how he didn't know if he could keep up with it. I simply replied that the only reason I was working other tasks was because he never said he needed my help until it blew up in his face. He talked to the supervisor and that was the end of it. So, med school won't be like that, but I'll definitely reserve my right to not put up with it if I'm not in the wrong or if he's got some pent up frustration with his own issues.

Shouldn't have let that initial yelling happen. If you look weak the bigger person will use you as displacement material.

 

[Kaustikos]

Shouldn't have let that initial yelling happen. If you look weak the bigger person will use you as displacement material.

It's about the situation, though. When I'm confident I haven't done anything wrong, then I won't bark bite.. If he isn't verbally/physically abusive, then I don't mind waiting and telling HIS supervisor. But I didn't straight out say he should stop bitching, I just naively asked my boss what was going on or if I was doing something wrong. This is also another side lesson on how to interact w/ nurses and hospital staff. If you come across as nice/naive/funny/humble, then they're more likely to help you.

And I know I won't be like people we describe. I've taught/helped A LOT of people and never was condescending or mean. I was sarcastic, yes, but they enjoyed it. Seems like being bullied can be resolved in many ways, I've learned several ways of dealing with the differing scenarios.

edit - and in actuality, it made my supervisor look weak and pathetic. My boss knew I was doing my job and went ahead and talked with my supervisor about this "issue".

 

[Anigma07]

It's about the situation, though. When I'm confident I haven't done anything wrong, then I won't bark bite.. If he isn't verbally/physically abusive, then I don't mind waiting and telling HIS supervisor. But I didn't straight out say he should stop bitching, I just naively asked my boss what was going on or if I was doing something wrong. This is also another side lesson on how to interact w/ nurses and hospital staff. If you come across as nice/naive/funny/humble, then they're more likely to help you.

And I know I won't be like people we describe. I've taught/helped A LOT of people and never was condescending or mean. I was sarcastic, yes, but they enjoyed it. Seems like being bullied can be resolved in many ways, I've learned several ways of dealing with the differing scenarios.

edit - and in actuality, it made my supervisor look weak and pathetic. My boss knew I was doing my job and went ahead and talked with my supervisor about this "issue".

Should have just straight up confronted your supervisor. Unless you stand up for yourself, you're going to get walked all over. Unneeded tension by going ot the boss without confronting the supervisor first, makes you look scared of him. I'd also be pissed if you went behind my back like that.

If you just hold yourself like a professional and have some confidence, you'll be fine. No one is out to get you.

 

[KnuxNole]

Sometimes you can't help getting bullied, ie: you remind them of their ex or someone that they hate, etc.

Those people who hate others because of a reminder of their ex probably should try to date more and not be a lame freak 😛

 

[Lawgiver]

I know this forum is dead, but I wanted to comment on this since I just received a phone call from a fellow nurse. She was talking to me about a new orientee that was being bullied. Poor thing. She's only 2 months out of nursing school, and the nurses have already seemed to collectively put her in the cross hairs to die.

It's just not right.

Regardless of whether or not you think we should just be silent, bow our heads, and make it through medical school.

It's not right. Medicine is tough, which is why it's more important than ever to build a culture of teamwork and compassion. Medical students who are too afraid to ask questions of an attending don't make for very good students. If you are too scared to ask, then how will you learn? Seriously.

I have been bullied in numerous fields. In research, in the hospital, in EMS. Yes you need a tough skin to deal with tough personalities, but that doesn't mean that anyone can treat you however they want. I think the best way to handle this is for students to stand up for each other.

This 'thread' is dead.

 

[da8s0859q]

This 'thread' is dead.

You mean the thread you just revived from almost 2.5 years ago?

 

[Lawgiver]

That's called irony. I bring it, you discover it = success.

 

[da8s0859q]

Figured it was probably intentional but was like, "would this person really bother?"

Apparently yes, yes, you would.

 

[GoSpursGo]

Yeah this discussion seems to have played itself out by now.