ObjectivesTo determine the extent to which undergraduate medical students experience (and/or witness) bullying and harassment during their first year on full-time placements and to compare with new General Medical Council (GMC) evidence on bullying and harassment of doctors in training.SettingA UK university offering medical and nursing undergraduate programmes.Participants309 medical and nursing undergraduate students with 30–33 weeks’ placement experience (123 medical students and 186 nursing students); overall response rate: 47%.Primary and secondary outcome measures(A) students’ experience of bullying and harassment; (B) witnessing bullying and harassment; (C) actions taken by students; (D) comparison of medical and nursing students’ data.ResultsWithin 8 months of starting clinical placements, a fifth of medical and a quarter of nursing students reported experiencing bullying and harassment. Cohorts differ in the type of exposure reported and in their responses. Whereas some nursing students follow incidences with query and challenge, most medical students acquiesce.ConclusionsBullying and harassment of medical (and nursing) students—as well as witnessing of such incidents—occurs as soon as students enter the clinical environment. This augments evidence published by the GMC in its first report on undermining of doctors in training (December 2013). The data suggest differences between nursing and medical students in how they respond to such incidents.

The study indicates the importance of preparing the practice adequately, including providing protected time for all GPs to attend the educational intervention. Scenarios and the structure of the sessions need to make more explicit the links between everyday practice and published evidence of effectiveness. Emphasis on cost-effectiveness may be counterproductive and wider benefits need to be emphasized. We have also identified the skill profile of the facilitator role. Our study indicates a need for a clearer understanding of GPs' perception of clinical autonomy and how this conflicts with the goal of agreement on practice guidelines for treatment. The intervention is now ripe for further development, perhaps by integrating it with other interventions to change professional behaviour. The improved intervention should then be evaluated in a randomized controlled trial.

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