The Prevalence of Medical Student Mistreatment and Its Association With Burnout

Abstract

Purpose Medical student mistreatment has been recognized for decades and is known to adversely impact students both personally and professionally. Similarly, burnout has been shown to negatively impact students. This study assesses the prevalence of student mistreatment across multiple medical schools and characterizes the association between mistreatment and burnout. Method In 2011, the authors surveyed a nationally representative sample of third-year medical students. Students reported the frequency of mistreatment by attending faculty and residents since the beginning of their clinical rotations. Burnout was measured using a validated two-item version of the Maslach Burnout Inventory. Results Of 919 eligible students from 24 different medical schools, 564 (61%) completed the survey. The majority reported at least one incident of mistreatment by faculty (64% [361/562]) and by residents (75.5% [426/562]). Notable minorities experienced recurrent mistreatment, defined as mistreatment categorized as “several” or “numerous” times by student self-report (10.7% [59/562] by faculty and 12.6% [71/562] by residents). Recurrent mistreatment was associated with high burnout (57.4% vs. 31.5%; p<0.01 for recurrent mistreatment by faculty; 49.1% vs. 32.1%; p<0.01 for recurrent mistreatment by residents). Conclusions Medical student mistreatment remains prevalent. Recurrent mistreatment by faculty and residents is associated with medical student burnout. Although further investigation is needed to assess causality, these data provide additional impetus for medical schools to address student mistreatment to mitigate its adverse consequences on their personal and professional well-being.

Mistreatment in an academic setting and medical students' perceptions about their course in São Paulo, Brazil: a cross-sectional study

“…It should be noted that this is an opportune time to bring this discussion to the forefront in this country, because the new national curriculum guidelines that were recently approved state that medical schools should be able to provide training for doctors to practice "general, humanistic, critical, reflective and ethical medicine (…) with social responsibility and commitment to the defense of citizenship [and] human dignity". 37 Considering the negative impact of mistreatment on mental health and wellbeing, and the way in which students perceive their course and academic achievements, 5,7,12,[16][17][18][19][20] occurrences of mistreatment during medical training have high potential to compromise quality of care and the way in which students approach their patients and their suffering. Mistreatment represents an additional source of stress for medical students that should be seriously taken into consideration by medical schools.…”

“…Those who are exposed feel more stressed and depressed, have low self-esteem and are more likely to consume alcohol and binge-drink. 5,7,12,[17][18][19] The different sources of stress to which medical students are exposed during their medical training are well known. 18,26,27 Medical education is hard to access and difficult to sustain, given the large amount of time dedicated to academic activities and the amount of suffering and distress that students need to cope with on a daily basis.…”

“…Although the effects on students' mental health, wellbeing and perceptions about medical education and academic achievements are well known, 5,7,12,[16][17][18][19][20] studies addressing the perceived severity and recurrence of mistreatment and the association with students' perceptions about their medical course are scarce. Most of the studies have been conducted in the US, and no data are available for Brazil.…”

Go Home, Med Student: Comics as Visual Media for Students' Traumatic Medical Education Experiences

“…Some students might experience anxiety related to even working, speaking, or listening to an attending physician like Dr. Charles, and their educational experience could suffer as a result. For example, a national survey of third-year medical students conducted in 2011 found that the majority of respondents reported at least one incident of mistreatment by faculty or residents since they began their clinical rotations [9]. A smaller subset of students also reported recurrent mistreatment by faculty or residents, and these students were more likely to have higher burnout than students who reported no or infrequent mistreatment [9].…”

“…For example, a national survey of third-year medical students conducted in 2011 found that the majority of respondents reported at least one incident of mistreatment by faculty or residents since they began their clinical rotations [9]. A smaller subset of students also reported recurrent mistreatment by faculty or residents, and these students were more likely to have higher burnout than students who reported no or infrequent mistreatment [9]. Although the survey did not define or give examples of "mistreatment," mistreatment could be defined in a variety of ways, including racial or gender discrimination, physical intimidation, or humiliation or belittlement (as in the case presented in figure 1).…”