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Why is this article important?
Harassment and discrimination are behaviors that are perceived as humiliating, hostile, or abusive. This article looks at the prevalence and sources of harassment and discrimination encountered by medical trainees. Interactions that trainees have during their training can be a source of encouragement, mentorship, and impact their career path. Abuse during training creates hostile work environments and induces stress and discomfort, which may impair performance.
Article Summary
What they looked at:
Studies that reported the prevalence, risk factors and sources of harassment and discrimination among medical trainees.
How they measured things:
2 reviewers independently performed a systematic review of 57 cross-sectional and 2 cohort studies using a standardized data extraction form. Then a Meta-analysis of 51 studies was performed.
What were their outcomes:
59.4% of medical trainees had experienced at least one form of harassment or discrimination during their training 95% confidence interval [CI]: 52.0%–66.7%).
Verbal harassment was the most commonly cited form of harassment (prevalence: 63.0%; 95% CI: 54.8%-71.2%).
Consultants were the most commonly cited source of harassment and discrimination, followed by patients or patients' families (34.4% and 21.9%, respectively).
One study found that 5% of the trainees included in their study were considering leaving their current specialty training program because of harassment and 39% were deeply disturbed.
sexual harassment remains the most common form of abusive behavior in U.S. training programs
Why do we care about this article?
Unfortunately there is still a very high prevalence of harassment and discrimination among those undergoing medical education. Changes need to be made on both an institution and cultural level to help ensure that this does not continue and then follow up studies need to be performed to look for success of interventions. Trainees also need to feel empowered to report incidences and know that action will be taken against abuse.
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Hu YY, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, Potts JR 3rd, Buyske J, Hoyt DB, Nasca TJ, Bilimoria KY.
N Engl J Med. 2019 Oct 31;381(18):1741-1752. doi: 10.1056/NEJMsa1903759. Epub 2019 Oct 28.
PMID: 31657887
Nagata-Kobayashi S, Maeno T, Yoshizu M, Shimbo T.
Med Educ. 2009 Jul;43(7):628-36. doi: 10.1111/j.1365-2923.2009.03388.x.