Medical student abuse during clinical clerkships in Japan

Abstract

OBJECTIVE: To assess the prevalence of medical student abuse during clinical clerkships in Japan. DESIGN: A cross‐sectional questionnaire survey. SETTING: Six medical schools in Japan. PARTICIPANTS: Final year (sixth‐year) and fifth‐year medical students in the period from September 2003 to January 2004. From a total of 559 students solicited, 304 (54.4%) returned the questionnaire, and 276 (49.4%: 178 male and 98 female) completed it. MEASUREMENTS: Prevalence of medical student abuse in 5 categories: verbal abuse, physical abuse, academic abuse, sexual harassment, and gender discrimination; differences in abusive experience between male and female students; types of alleged abusers; reporting abusive experiences to authorities; and emotional effects of abusive experiences. RESULTS: Medical student abuse was reported by 68.5% of the respondents. Verbal abuse was the most frequently experienced abuse (male students 52.8%, female students 63.3%). Sexual harassment was experienced significantly more often (P<.001) by female students (54.1%) than by male students (14.6%). Faculty members were most often reported as abusers (45.2% of cases). Abuse occurred most frequently during surgical rotations (42.0% of cases), followed by internal medicine (25.1%) and anesthesia rotations (21.8%). Very few abused students reported their abusive experiences to authorities (8.5%). The most frequent emotional response to abuse was anger (27.1% of cases). CONCLUSIONS: Although experience of abuse during clinical clerkships is common among medical students in Japan, the concept of “medical student abuse” is not yet familiar to Japanese. To improve the learning environment, medical educators need to take action to resolve this serious issue.

The Perception and Experience of Gender-Based Discrimination Related to Professional Advancement among Japanese Physicians

“…Our result supports the findings of previous studies on sexual harassment in the physician workplace: female physicians experience gender based harassment from colleagues, superiors, and patients (Komaromy et al 1993;Phillips and Schneider 1993;Witte et al 2006;Shrier et al 2007). Previous studies on the prevalence of sexual harassment among Japanese medical students and residents showed that 54.1% of female students and 58.3% of female residents experienced sexual harassment during their education or clinical training (Nagata- Kobayashi et al 2006Kobayashi et al , 2009. Our study, together with these findings, suggests that women experience gender-based mistreatment throughout their career.…”

“…Although a few studies have evaluated experience of disparate treatment based on gender among medical students and residents (Nagata-Kobayashi et al 2006, little is known about the prevalence of gender discrimination among Japanese physicians. In this study, we examined the perception of gender-based obstacles for women and the prevalence of experiences of gender discrimination among physicians in Japan.…”

Exploring medical students’ barriers to reporting mistreatment during clerkships: a qualitative study

“…Specifically, medical students who are subject to abusive behaviors are more likely to experience mental health issues such as post-traumatic stress [3,4], depression and low career satisfaction [5], and even suicidality [6]. More than three decades of studies have shown that the behavior of faculty, residents, and nurses toward medical students can be unprofessional and abusive, particularly during clinical clerkship rotations [1,5,7,8]. A meta-analysis demonstrated a high prevalence of harassment and discrimination toward medical trainees worldwide, with 59% of medical trainees experiencing at least one form of harassment or discrimination during their training [8].…”

Concepções sobre assédio moral: bullying e trote em uma escola médica

“…Mas e o estudante de Medicina? No início da década de 1980, foi difundido o termo "abuso" para descrever situações de violência vivenciadas por estudantes de Medicina na escola médica, à semelhança de violência de familiares contra crianças, tanto pela identificação de [19][20][21][22][23][24][25][26][27][28][29] . Entre as repercussões adversas sobre a saúde do estudante, os estudos citam depressão e alcoolismo, e sobre a relação do estudante com a própria profissão algumas consequências assinaladas foram maior cinismo, perda da capacidade de percepção do que é correto e desejo de abandonar a carreira médica 19,22,24,[27][28][29] .…”