Navigating Mistreatment in Medical Education: Students’ Experiences

Background

Mistreatment of medical students (MS) are widely documented globally. Mistreatment encompasses gender and racial discrimination, public humiliation, and disrespect etc. and is associated with mental health issues such as stress, anxiety and burnout. The aim of the study is to explore the experiences of mistreatment among Danish MS and junior physicians (JP) enrolled in Clinical Basic Education, how these experiences have affected them, and the strategies they use to cope.

Methods

Semi-structured interviews with 27 JPs and MS were conducted from May to September 2023. An interview guide, focused on experiences with and responses to mistreatment was developed. Interviews were conducted face-to-face or online. All MS signed a written consent form. The authors thematically coded the data (with each coding half), and then discussed collaboratively and merged into a single dataset.

Results

Three main themes were identified in the analyses. 1. Reporting of mistreatment: MS were unsure about where to seek help, accepted the culture of “the clinic”, and were reluctant to share their experiences with clinical teachers out of fear of academic consequences. 2. Coping strategies: MS handled mistreatment by keeping things inside, visualizing status as physician or reaching out for support from supervisors or peers. 3. Implications for learning: MS experienced missed learning opportunities and a disconnect between the formal and hidden curricula.

Conclusions

Danish MS experience mistreatment during medical school, which negatively impact their learning opportunities. Due to clinical hierarchies, cultural factors, and uncertainty about where to seek help, they often feel insecure about reporting incidents. Moreover, MS adopt various coping strategies to navigate these experiences. This highlights the need for targeted interventions to raise awareness of mistreatment and foster an inclusive educational environment that supports the well-being and success of MS.

Key messages

• Medical students cope with mistreatment in various ways, often choosing not to report incidents due to clinical culture, hierarchies, and fear of negative repercussions on their academic progress.

• Medical students are often unsure where to seek help for mistreatment during clinical rotations, highlighting the need for university action to ensure support and an inclusive learning environment.