PurposeHarassment and discrimination include a wide range of behaviors that medical trainees perceive as being humiliating, hostile, or abusive. To understand the significance of such mistreatment and to explore potential preventive strategies, the authors conducted a systematic review and meta-anal

Harassment and Discrimination in Medical Training: A Systematic Review and Meta-Analysis

Medical students are exposed to multiple factors during their academic and clinical study that have been shown to contribute to high levels of depression, anxiety, and stress. The purpose of this article was to explore the issue of depression in the medical student population, including prevalence, causes, and key issues, along with suggestions for early identification and support from one medical school in New Zealand. After establishing that the prevalence of depression is higher for medical students than the general population, the key issues explored include assessment used in the program, characteristics of the student population (such as Type A personality and perfectionism), resilience, selection procedures, students' motivation, and the nature of the clinical environment. This review includes several recommendations to improve students' psychological health such as positioning well-being within an overarching comprehensive workplace wellness model and integrating peer and faculty-led support into the day-to-day running of the institution. It also highlights the advantages of the addition of a well-being curriculum, as skills to prevent and manage distress and depression are relevant in supporting the competencies required by medical practitioners. It concludes that medical schools need wide-ranging strategies to address the complexities associated with the particular student population attracted to medicine and calls for educators to act, by noticing opportunities where they can introduce such initiatives into their medical programs.

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Depression in medical students: current insights.

Developing professionalism is a core task in medical education. Unfortunately, it has remained difficult for educators to identify medical students’ unprofessionalism, because, among other reasons, there are no commonly adopted descriptors that can be used to document students’ unprofessional behaviour. This study aimed to generate an overview of descriptors for unprofessional behaviour based on research evidence of real-life unprofessional behaviours of medical students. A systematic review was conducted searching PubMed, Ebsco/ERIC, Ebsco/PsycINFO and Embase.com
 from inception to 2016. Articles were reviewed for admitted or witnessed unprofessional behaviours of undergraduate medical students. The search yielded 11,963 different studies, 46 met all inclusion criteria. We found 205 different descriptions of unprofessional behaviours, which were coded into 30 different descriptors, and subsequently classified in four behavioural themes: failure to engage, dishonest behaviour, disrespectful behaviour, and poor self-awareness. This overview provides a common language to describe medical students’ unprofessional behaviour. The framework of descriptors is proposed as a tool for educators to denominate students’ unprofessional behaviours. The found behaviours can have various causes, which should be explored in a discussion with the student about personal, interpersonal and/or institutional circumstances in which the behaviour occurred. Explicitly denominating unprofessional behaviour serves two goals: [i] creating a culture in which unprofessional behaviour is acknowledged, [ii] targeting students who need extra guidance. Both are important to avoid unprofessional behaviour among future doctors.

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Descriptors for unprofessional behaviours of medical students: a systematic review and categorisation.

Physiotherapy students' experiences of bullying on clinical internships: a qualitative study

OBJECTIVE To identify factors associated with a history of suicide attempt in medical students. METHODS A Web-based survey was sent out to a sample of medical students. A multi-predictor Poisson regression was performed to identify factors associated with a history of suicide attempt. In addition, an elastic net regularization was used to build a risk calculator to identify students at risk for attempted suicide. RESULTS A total of 4,840 participants were included in the study. Prevalence of suicide attempts in the sample was 8.94%. Risk factors associated with past suicide attempt in the multi-predictor Poisson regression were as follows: female gender (P < 0.001); homosexuality (P < 0.001); low income (P = 0.026); bullying by university peers (P = 0.006); childhood (P = 0.001) or adult (P = 0.001) trauma; family history of suicide (P = 0.005); suicidal ideation within the last month (P < 0.001); daily tobacco use (P = 0.037); and being at severe risk for alcohol abuse (P = 0.023). Our elastic net model performed well with an AUC of 0.83. CONCLUSIONS This study identifies a number of key factors associated with a history of suicide attempts among medical students. Future longitudinal studies should assess the causal relationship between these factors and suicide attempts. Additionally, these results demonstrate that current available data on suicide attempts among medical students can be used to develop an accurate risk algorithm.

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Who attempts suicide among medical students

Objective: To assess the frequency and forms of bullying experienced by medical students, and the associated factors. Study Design: Cross-sectional questionnaire-based survey. Place and Duration of Study: The study was conducted at a private Medical College of Lahore, from January to February 2010. Methodology: All the students of first and fourth year classes were included in the study with voluntary and anonymous participation. Self administered-questionnaires were given to the students which were completed by them in the presence of the surveyor. A modified version of the British Medical Associations (BMA) medical student’s welfare and education survey form was used for data collection. The data was recorded and analyzed using the statistical package for social sciences version 16.0. Data was described in the form of frequencies and percentages. Chi-square test and Fisher exact test were used to test statistical significance between categorical variables at p < 0.05. Results: More than half the students 70 (66%) had experienced some form of bullying in the past 6 months at the Medical College. It was found that 70% (49) of the students who were bullied were females. Sixty-seven percent of students reported experiencing a bullying episode at least once in a month, 26% less than once in a month and 7% at least once in a week. The most common forms were verbal abuse (n=44, 63%) and behavioural gestures i.e. making faces (n=36, 51%), followed by having been ignored or excluded (n=20, 29%). The common perpetrators of all types of bullying were fellow students followed by Professors. Feeling lonely or sad (p=0.024), not having a close friend (p=0.049) and knowledge amongst respondents regarding the availability of support services in their college (p=0.019) were significantly associated with being bullied. Conclusion: Most medical students reported of having been bullied in the last 6 months at the College, with verbal abuse being the commonest form of maltreatment and fellow students followed by Professors being the frequent perpetrators. A history of feeling lonely or sad, not having a close friend and knowledge amongst respondents regarding the availability of support services in their college were significantly associated with these experiences.

Mehvish Naeem

Papers

Bullying of medical students.