Bullying reported by more than a third of medical trainees
Many who experience bullying, discrimination or harassment say it has negative effects on their training.
Workplace culture continues to be a serious issue in medical education, according to the latest National Medical Board of Australia (MBA) Medical Education Survey to confirm.
Findings show little improvement in workplace culture, with issues such as bullying, harassment and discrimination still being encountered, particularly among Aboriginal and Torres Strait Islander trainees.
More than 21,000 medical trainees – more than half of the current cohort – took part in the 2021 profession-wide survey, designed to respond to feedback and identify key issues to inform policy recommendations Australia’s National Physician Workforce Strategy.
While all aspects of the quality of trainee supervision have improved since 2020, with 80% of respondents recommending their training program and current workplace, 35% experienced or witnessed bullying, harassment and /or discrimination, including racism.
Those affected suggest that senior medical staff are most culpable, with 51% saying they have experienced bullying, harassment and/or discrimination from this source, while 54% have seen senior medical colleagues adopt this type of behavior.
These numbers represent no improvement over previous years, further underscoring the serious and persistent issues that often lead to stress, burnout, depression, and even suicide among young physicians.
About 38% of trainees who experienced bullying, discrimination and/or harassment said in the survey that it had “moderate” or “major” negative effects on their training.
For Aboriginal and Torres Strait Islander trainees, these numbers are worse. Fifty-two percent experienced some form of bullying, discrimination and/or harassment, and 49% reported a “moderate” or “major” impact on their training.
MBA President Dr Anne Tonkin said the survey results provide important insights into the medical culture in the workplace, the quality of training and areas for improvement.
‘From year to year, [survey] the results show that a lot is going well in medical education in Australia,” she said.
“But some small changes in 2021, which may be related to the impact of the pandemic, deserve special attention in the years to come.”
Dr. Jacinta Power is an Indigenous woman and a recent medical graduate from James Cook University (JCU), now working for JCU’s General Medicine training.
Although she had not experienced any bullying, harassment or discrimination throughout her GP training, she was certainly aware of the issues.
“My experiences were very mixed during the clinical rotations,” said Dr Power. newsGP.
“Some rotations we had lovely, caring consultants and others didn’t care if you were there or not, and you felt like a fly on the wall that couldn’t move for fear of getting in the way.”
Dr. Power attributes his positive training experiences to supportive medical educators who provided additional exam training, in addition to the routine teaching provided, as well as three “incredible” clinical rotations.
“I had passionate supervisors willing to teach and it also appreciated a healthy work-life balance for me having a young family,” she said.
Additionally, the support Dr. Power received from the Indigenous General Practitioners Registrar Network positively impacted her training experience.
‘[This] provided a culturally safe space to draw strength from our crowd who often went through similar life and study issues,” she said.
The importance of a culturally safe space is also highlighted in the results of the Medical Training Survey, which found that Aboriginal and Torres Strait Islander trainees were 1.5 times more likely to be victimized and/or witnesses of bullying, harassment and/or discrimination than non-Aboriginal people. Australian trainees.
“Troublingly, there is a significant and unacceptable difference in the incidence of these problems reported by Aboriginal and Torres Strait Islander doctors in training,” Dr Tonkin said.
“Racism in healthcare is never acceptable and we all need to do better.”
These results represent little progress from previous years of the survey, and a report 2017 survey of Australian Indigenous Doctors’ Association members on bullying, racism and lateral violence also confirms that reducing health care disparities – a key strategy of Closing the Gap – is little likely to be achieved without addressing systemic racism.
Part of this strategy is to strengthen the health workforce with more Aboriginal and Torres Strait Islander people, which the RACGP has long advocated for.
The 2020 General practice: Nation Health report that there has been a 55% increase in the number of Aboriginal and Torres Strait Islander students pursuing careers in medicine compared to the previous three years, and these numbers are expected to rise.
Dr Power said that while she had not personally experienced any bullying, harassment or discrimination during her GP training, her hospital training was a completely different experience.
“I had a very different experience in my hospital training where there was a strong undercurrent of competitiveness that would be construed as bullying,” she said.
“I still get a sick feeling in my stomach thinking about it.
“For an Indigenous doctor who was already on a difficult path to get to where he is today, it amplified that feeling of impostor syndrome.
“As a trainee doctor, another difficult area to deal with was the number of racist comments made, often unknowingly and by several hospital staff, not often directed at me but at our crowd of patients.
“It was a daily occurrence in hospital training and it was about choosing which battles to fight and which not to fight because it was just too tiring to be that person to always say something. .”
However, Dr Power says the survey provides insight into how the medical culture in the workplace can be improved, particularly for Aboriginal and Torres Strait Islander people.
‘Learning from what went well for those who had great experiences [and] building on the values and teaching of leaders and teachers who inspire and receive positive feedback from their trainees [would be invaluable],’ she said.
“For Aboriginal and Torres Strait Islander medical trainees, there is still a long way to go in understanding what cultural safety is for our crowd. It’s slowly changing, which is great, but there’s still a long way to go.
“Cultural education must be integrated for everyone involved in health care up to the level of administration.”
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