The Bullying Culture of Medical School

Pre-Med & Medical School Pre-Med Topics
21

<p>A “problem” for us is that we have almost never yelled at our kid. He is inclined to follow the rule too well and we (or teachers) rarely have any need to disapprove of whatever he does.</p>

<p>His music teacher from early childhood to the end of high school could be the person who gave him some exposure to this kind of “training.” She is not shy about criticizing the kid because this is her job. Unfortunately, she liked DS very early on, so he got yelled at much less frequently than most other students.</p>

<p>Comparing to my own upbringing, I think DS is indeed much more “academically/emotionally sheltered.” When I was growing up, i believe I was yelled at likely 10 times more often than DS. I do not think DS’s eperience is unique. The parenting style of the “helicopter parents” generation is very different from that of the previous generation.</p>

22

<p>As the son of the football coach, and the lacrosse coach, and the English teacher, and being the center on the football team (every bad snap was my fault even if the QB botched the count), I learned a long time ago that any process which demands expertise and skill takes a lot of practice, persistence, and the ability to withstand criticism…go with the flow…if you get yelled at so what? Move on and get better…better yet, get amped up and work harder…</p>

23

<p>

OK, if it’s your fault, fair enough. If the doc is having a bad day and is dumping on the student or other staff because that’s his therapy, this doesn’t apply.</p>

24

<p>Eek! DD (current M1) has never, as far as I know, been yelled at in her life. Constructive criticism, yes. Yelled at, no.</p>

25

<p>Lots of things aren’t fair. Coaches aren’t fair. Teachers aren’t fair. Doctors don’t have a lock on unfairness . </p>

<p>If you rate your days as a MS3 as to whether or not you were treated fairly and with due respect by all you meet, I bet you won’t have many highly rated days. </p>

<p>Does that mean I am making excuses for boorish behavior? No. Just saying that if prepared you can deal with it. Usually. ;)</p>

26

<p>My H works with residents and students and his preferred choice of “bullying” is quizzing students on nonmedical topics. I think word has gotten out over the years and the students brush up on astronomy and history before entering my H’s rotation. I’m sure he does the medical stuff, too, but the real pride goes to those who correctly answer his off topic questions. :)</p>

27

<p>I don’t know the specifics of it, but D who has just started MS1 said they talked about this topic multiple times during orientation. She said they put a program a year ago in place to annonomously report “bulliy dr’s” or even mistreatment of patients. She said they reported within the first year that the changes were astronomical. I hope so, as my unit is a people pleaser.</p>

28

<p>BUandBC, my DS would love to be on your H’s rotations! </p>

<p>I told him I need to yell at him more often and he reminded me he read the article and said, “Okay!”.</p>

29

<p>GAMom- While reading this thread I kept thinking that the bullying drs. are not only abusive to students but also patients and was glad to see that it can be reported. My first baby was delivered by a rude, rude doctor. He yelled at me because the labor pains were so bad that I was writhing around during his exam. It was my first child and I was not prepared for the pain. His rant included shouting complaints about how I was able to keep my legs apart long enough to get pregnant. This guy was a such a tool.</p>

<p>Years later, a mom at my daughter’s cheerleading gym , who is an L&D nurse, told me stories about how the nurses get to the point where they remind this doctor of decorum. They make no bones about it and remind him of where he is and proper behavior. I believe it- they probably got flat-out tired of his boorish, insensitive behavior.</p>

30

<p>I told my own D. to IGNORE. This is a reflection on people who are making others feel bad, so it should not be taken personally. These people also might be influenced by their culture. D. was dismayed because she did not meet these type at her UG. I told her that this is because that she tried very hard to avoid these type of personalities in a past. It was possible because of wider choices. Now she is forced to work in groups that are purposely mixed every block. I told her to look at this situation from positive prospective - it is better learn earlier than later. She has agreed about that. however, at crunch pre-exam time when she has to psych herself up all the time, being around these people makes it much harder.<br>
D. has lots of friends, it helps and she was told by her advisor that she is done well so far which is also supported by the fact that she was presented with several selective opportunites that were not open for everybody in her class. she always ask herself “Why?”, I say, take it and enjoy, “why?” is too deep question to ask. She has only 2 blocks, then she starts rotations. I hope that she will be much stronger person to face situation, where she will be at the bottom of the pack. So, I love that she is presented with this type of challnge at her school.</p>

31

<p>Abuse very well can lead to further abuse in some people. If a person doesn’t deal with and properly heal from abuse, then they may do the same thing to others. </p>

<p>You see it quite a lot in studies. I’m not sure of the psychology behind it…but it’s very very common that abusers were abused themselves. I don’t know exactly what the logic is…maybe others do. </p>

<p>Also, this is NOT just common in medicine, but in almost EVERY field or social sphere of society. You see it from elementary school playground bullying to college frat hazing and sports team bullying…to bullying in the military…to bullying at low-wage unskilled labor types of jobs…all the way to graduate school and professional levels (where people are highly educated). </p>

<p>What I’ve been told is to always document document document. Sometimes you may not be able to immediately figure out a person’s intentions…liek if you misheard something or misinterested something or it’s a ONE time anamoly, etc. …but if you suspect something and it’s happened twice or more…then start documenting. Heck, even after the first time…maybe document. You can’t always figure everything out yourself and aren’t expected to frankly, lol…these people can be real socio-paths. I’ve heard sometimes a REALLLLLY crafty abusers will be nice to you AND abuse you so you sort of stay with them and mayhbe even feel guilty yourself as in wondering if YOU are the problem. </p>

<p>But regardless of whether or not something really is bully…just document and have a trusted friend or professional counselor, etc. look at what’s happened from an outside perspective. Some of that behavior, in addition to being unprofessional, may even rise to the level of being criminal??..as in emotional abuse and threats? So try to have witnesses, try to document, and have people objectively look at your situation. </p>

<p>In the meantime, try to just focus on your work realizing in the back of your mind that you have a plan to deal with this. It’s when you don’t have a plan taht it’s really destructive and can disturb your peace and lead to lower productivity. I worked a year at a min. wage job part-time during my first year of college. </p>

<p>There was a guy on my team that always bullied me. He did it in front of his friends, but didn’t do it with the cool and social folks. I’m a bit on the shy side in person, so he picked on me a lot. But when the cool crowd or the more social folks were around that were not his friends, then he’d jsut keep to himself. He was like a COWARD…going after me only when he had numbers. I mostly kept quiet adn didn’t know how to deal with it. I never told my parents or anyone. I was ashamed and honeslty thought I was weak for not being able to stand up to him. </p>

<p>BUT, after countless times of bullying me…one night I had had enough and yelled back at him and stood up to him…he started laughing a little, but then I realllly got in his face (I wouldn’t do that again…it’s NOT me…but just a heat of the moment loss of control of anger…) and cursed him out really bad and he was really surprised. …He stopped laughing and actually backed off lol…there was one other person around that he wasn’t close friends with, so he had no back up. It was just us three and he said </p>

<p>“Hey calm down calm down man…I was just joking…C’mon man you know I was just playing…” </p>

<p>I DIDN’T know, nor did I believe him…I think he WAS trying to bully me…but I think he was shocked I stood up and could get that mad. He finally backed off after that and never really bullied me again. Maybe very very very rarely he’d make a subtle remark here or there, but it was never the same after that.</p>

<p>In hindsight, what I would ahve done rather than yell at the guy back…kind of counter-productive, lol…is to just document it and tell my boss!!! Such a simple thing to do, but at the time I was inexperienced and ashamed. It’s because the way he joked me was to take things I was very self-conscious about and make fun of those things. So it would have been tough to tell others b/c I was already embarassed of those things. …But if I could go back in time, I’d just really let someone know, b/c that’s really the best way to handle things.</p>

32

<p>Let me also add…I wonder if there are different types of bullying distinctions we should make? </p>

<p>Ok, in my story above, the guy bullying me was not telling me off WHEN I MADE A MISTAKE. He was OUT TO GET ME…I never made fun of me for making errors on the job…well maybe he would if he was like perfect…since he made errors himself too, lol…but instead he’s make fun of how I looked or my background and other characteristics personal to my identity. He purposely tried to hurt my feelings for whatever sick reason he had in his mind. </p>

<p>Now…with these medical doctors yelling at medical students…if it’s ONLY when they mess up and the doctors don’t go out of their way to pick on these students otherwise, then maybe that’s different? I’m not saying they SHOULD abuse people even when the mess up…but just saying that that’s different. </p>

<p>If you’ve ever watched an NBA game…there are millionaire athletes getting chewed out really bad in front of the whole nation in big games when they mess up. These coaches probably curse and may or may not call them names. …I’m not saying at all that that’s OK or the best way to go about things…but asking if it’s mayyyyyyybe possssssibly just a kind of “tough love” or “tough criticism” to get a person’s attention to immediately improve? </p>

<p>Has anyone ever watched that show “Hell’s Kitchen” with that British chef who curses and yells and name calls his contestants? …I get the sense that people actually love Gordon Ramsay and appreciate the opportunity to learn from and work with him, despite his potty mouth and temper tantrums and throwing pans and breaking dishes when he’s mad. He’s one of the greatest chefs in the world and in order to train up competent chefs he needs to make sure they perform up to his standards. Of course he could use OTHER techniques, but his methods do tend to be bully-like and crass and rude. </p>

<p>Check him out in action: [Gordon</a> Ramsay Hell’s Kitchen Medley Of Insanity #1 - YouTube](<a href=“Gordon Ramsay Hell's Kitchen Medley Of Insanity #1 - YouTube”>Gordon Ramsay Hell's Kitchen Medley Of Insanity #1 - YouTube)</p>

<p>I’ve heard some people argue that he purposely breaks people down (to humble them) ONLY to build them back up later (he has a soft side too). He wants perfection and has high standards and wants people to do better. So he uses his abrasive ways to go about it. </p>

<p>I wonder if tehre’s maybe a bit of similarity with medical doctors or coaches…or anyone in a position of power who criticizes when people make MISTAKES…that’s the key is that they only behave this way if you make a mistake. Maybe it’s a style of tough love???</p>

<p>Again, I"m not justifying it,b ut just maybe trying to put it into context???</p>

33

<p>The only thing that ANYBODY could do is to IGNORE and never ever take it personally. D. just got very nice group for this block and is very happy. However, she has mentioned yet another time that she is very glad that she had an opportunity to be with others who are way to tense for her taste, who tend not let people speak. It was an awesome learning experience. If you are not taking it for what it is (learning experience), than all your suffering is wasted. My own D. will never ever treat others like this, she will not go down to this level of treating people.</p>

34

<p>After reading the thread again, I think there are a few points to make.</p>

<p>First the OP is talking about “master servant” type bullying, not peer to peer or playground bullying. Someone in a position of power over the med student. The dynamic is really much different. </p>

<p>Secondly, what is considered bullying or inappropriate behavior to one is not necessarily bullying to all. </p>

<p>Third, and probably the most important to me, these students weren’t raised the same way. Their sensitivities are different. Their tolerances are different.Their learned responses and defense mechanisms are different. </p>

<p>I tell all parents that IME “parenting is controlled by the ‘Law of Un-intended Consequences’”. Wherever you push as a parent, it is gonna pop out somewhere else. Protect them from all harshness and conflict, and they may not be able to deal. Don’t protect them at all, and risk "injury’ that way. All we can do is use our best judgment based on the personality of our own kids. Other than that, hey. They can tell it to the shrink. We did the best we could with the then available data. ;)</p>

35

<p>I think all of us have dealt with people who treated us less than well. But there’s a big difference between being treated less-than-well and being mistreated. The first is a misguided attempt to help students learn. The second is purposeless and often dangerous.</p>

<p>Kicking someone out of the OR when they say or do something the attending doesn’t like is mortifying and tear-inducing. But students try and figure out what they did wrong (or what that particular attending thinks was wrong even if it was something that a different attending specifically wanted the student to do) so that it doesn’t happen again. That’s where the student has to accept that sometimes in their training they will be made to feel like abject failures through no real action on their own part.</p>

<p>Throwing sharp instruments in the OR is never acceptable. It won’t correct behavior, it’s dangerous to whoever the instrument was thrown at/in the general direction of, it disrupts everyone in the OR, and (most importantly) it’s dangerous to the patient. If nothing else, it should be reported to the clerkship director, who can keep students from working with that person again. And if it’s a resident that does it, the problem will be corrected.</p>

<p>I was lucky enough that though I was treated less than well a number of times (all of us are), I was never mistreated. I think that this is, in hindsight, the way most people feel about how they were treated as medical students.</p>

<p>PS: I just used surgery as an example. In my experience, the closest I ever came to frank mistreatment wasn’t actually in surgery, so it’s definitely not limited to one field.</p>

36

<p>@ MiamiDAP, if your daughter is distressed by percieved bullying by her own classmates during the two pre-clinical years, attendings, residents and even MS4s are going to make her life a living hell when she starts her clinical rotations. The senior residents are probably the most toxic of the bunch and can be unbelievably cruel and threatening. I think you are going to have to talk with your daughter before her rotations begin and develop some sort of strategy to cope with it. During my Surgery rotation as an MS3 I tried to return the verbal abuse in kind and on a number of occasions invited particularly abusive residents to follow me out to the parking lot and we could settle it there. When they realized I was serious, they pretty much kept their distance from me and tormented other MS3s.</p>

<p>Challenging abusive residents to a fight is probably not an option for your daughter but she can not allow herself to become a victim because that leads to worse victimization. There were a lot of women in my class and many were victims of bullying and one was even assaulted by a particularly wretched attending during an away rotation. However nearly all found a way of coping although it is sometimes very difficult.</p>

37

<p>Again. Sounds nice.</p>

38

<p>Charming…</p>

39

<p>See… this is where D1’s years of waitressing experience comes in handy. She’s perfected her techniques for dealing with a$$****s [drunk and sober] over nearly a decade. (And none of them involve spitting in their food in the kitchen before she serves it.)</p>

40

<p>“The senior residents are probably the most toxic of the bunch and can be unbelievably cruel and threatening.”</p>

<p>My daughter in her pediatrics rotation already has had runins with one resident who kept belittling her because she wrote .6 instead of 0.6 and actually reported it to her school.</p>