4 Corners aired a report At Their Mercy about sexual harassment and bullying in medicine on Monday night. It has played an important role in keeping the conversation going regarding a culture shift that some believe is long overdue in medical training.
At Their Mercy
4 Corners interviewed a number of people who have been vocal about the toxic culture that exists in some teaching hospitals throughout Australia:
- Dr Caroline Tan said that when she was a registrar, the message was “Don’t rock the boat, don’t complain, never complain.” Following a serious sexual harassment incident at the hands of her supervising surgeon, Dr Tan says that professionally, she finds that “doors are closed to me that would otherwise be open to other people.”
- Dr Gabrielle McMullin, the vascular surgeon who was at the centre of a controversy in March said that “It is very dangerous to either refuse a sexual advance when it happens or complain about it.” She also says “It’s one of the failings of the training scheme that all of the trainees are at such mercy of their supervisor.”
- Dr Helen Schultz, a Victorian psychiatrist said that “I think any profession where there is a hierarchy: there’s going to be perhaps some form of bullying. Wherever there’s power and a disparity of power, ah, some people will use for good and be great leaders and, and really influence people and embrace new people coming along with new ideas. And other people will be completely abusive of their power. And that certainly happens in medicine.
It’s important for people to understand that we still work largely within an apprenticeship model, so the people that are, are often our bullies are our direct supervisors. They’re the ones that sign off on us on every rotation. They’re the ones that provide references. They’re the ones that we’re frightened of; that we really, really want to impress. And they’re also the ones that are capable of bullying.”
- Dr Vyom Sharma said that on his first day as an intern he was told by his surgical registrar to forget what he’d learned in medical school about medicine being a team environment. He was told to follow the registrar’s orders as the registrar was following their boss’ (the consultant’s) orders. He was subjected to verbal abuse behind closed doors by the surgical registrar. After seeing the cycle of bullying that existed in surgical training, Dr Sharma gave up on his ambition to be a surgeon and now practices as a GP.
- Graeme Campbell – 4 Corners reporter Quentin McDermott asked Graeme Campbell, Vice President of the Royal Australasian College of Surgeons whether there is a cycle of bullying where young surgical registrars learn how to behave from their senior colleagues. Mr Campbell said ,”Um, actually, that’s one of the things I fear might be correct. Um, and w-we often learn from role modelling, from, from our seniors. So if we’re taught in an intimidatory way or, um, behaviour that’s intimidatory or, ah, not respectful, ah, is role-modelled: ah, young, younger, younger doctors can adopt those, adopt that. And that’s a cycle we need to break, ’cause that’s not where we want to be.”
- A medical student – A medical student who chose to remain unidentified out of fear of retribution said that during his training
“There was a culture or an acceptance that teaching by belittling was OK and was acceptable – and not just acceptable but was the way to do things.
It, it made me feel worthless. It made me feel like I knew nothing, which wasn’t true. Ah, it made me feel like I was dangerous, ah, and that I was going to kill someone.
I just started going very, very downhill and I, I ended up in a very dark place. I was severely depressed. I, I’d stopped enjoying anything. I didn’t want to go to university. I didn’t want to go to the hospital. I didn’t want to see friends. I wasn’t eating much. Um, and… I just, I didn’t see a way out. I ended up, about two months after the rotation, attempting suicide and I nearly succeeded. And afterwards, when I hadn’t, I wished that I had.”
The medical student did recover after receiving psychiatric treatment.
- Dr Imogen Ibbett made claims about Dr Helen Maroulis, a neurosurgeon at Monash Medical Centre. Her allegations include “constantly being made to feel that I wasn’t good enough, um, constantly being made to feel that I was, um, missing things, that I was lazy, um, that I was stupid. Um, and, and that was really exactly how she said it as well.”
When asked whether Dr Ibbett had been singled out, she said “No, no, absolutely not. Um, most of the, the other registrars that I worked with, um, have had similar experiences.”
To see the reaction to the 4 Corners story on Twitter, search for the hashtag #AtTheirMercy, or #4corners from 25th May. Following are just four of the tweets:
— Carlo Caponecchia (@psycarlogy) May 25, 2015
— Jackie (@simplyjak) May 25, 2015
Will there be change in the way future doctors are trained?
In March 2015 the Royal Australasian College of Surgeons (RACS) was quick to set up an advisory group to deal with claims of discrimination, bullying and sexual harassment in the practice of surgery.
In May 2015 the RACS expert advisory group released an independent prevalence survey to all of its Fellows, trainees and international medical graduates in order to reveal the extent of the problem. The survey will be administered in a way to keep the results confidential and anonymous.
The survey needs to completed and submitted by 9th June.
On 28th May, RACS said they had already had over 600 surveys submitted.
Thanks 600+ Fellows/trainees/IMGs who completed our survey on bullying. Keep them coming, pls encourage colleagues. http://t.co/POGvO9hwCd
— RACSurgeons (@RACSurgeons) May 28, 2015
The RACS will then be publishing and consulting on an Issues Paper. They will be seeking feedback about causes, general themes, and the actions required to stop discrimination, bullying and sexual harassment from occurring in the surgical profession. Cardiothoracic surgeon Dr Nikki Stamp has implored RACS Fellows to complete the survey whether they have been bullied or not, saying that the RACS “are a group who have a very real chance to make a difference. Urologist Dr Henry Woo has shared his thoughts on Twitter:
Ear nose and throat surgeon Dr Eric Levi has said that it’s not all bad in the health industry!
Bullying and harassment has been on front page news. In reality, the health industry is full of inspiring people. http://t.co/I63BHUcCVa
— Dr Eric Levi (@DrEricLevi) May 29, 2015
Advocate against bullying Dr Sally Cockburn appears to have something up her sleeve:
Just going thru my records of trainees I’ve advocated for. @RACSurgeons I’m going to follow up how u dealt w docs who behaved badly to them
— Dr Sally Cockburn (@DrSallyCockburn) May 25, 2015
Dr Helen Schultz gave instructions on how to spot a bully in medicine and what to do about it:
— Brian Fernandes (@BrianFern_) May 30, 2015
The mental health of doctors and doctors in training
The Medical Board of Australia and the Australian Medical Association have joined forces to create a national health program for doctors and medical students. A subsidiary company of the AMA, Doctors Health Services Pty Ltd will be funded by the Board.
AMA President Associate Professor Brian Owler said ‘The AMA is very pleased to be playing a central role in this project’.
‘Critically, the services will remain at arm’s length from the Medical Board to ensure that doctors and medical students trust these services and use them at an early stage in their illness’ he said.
Support is available for those who are experiencing suicidal thoughts or if you know someone who is:
- 1300 22 4636
- 13 11 14
- Suicide Call Back Service
- 1300 659 467
More articles on My Health Career:
- Why I would like to congratulate surgeon Dr Gabrielle McMullin for her suggestion that female trainees give into sexual harassment in the workplace
- Sexual harassment in medicine – it’s one thing to come forward anonymously to the media, but another altogether to make formal allegations against your boss
- President of Royal Australasian College of Surgeons denies sexual harassment is rife as Dr Sally Cockburn encourages trainees to talk to a “#safeDIT
- College of Surgeons forms an advisory group to deal with reports of bullying, sexual harassment and discrimination
- 49% of RACS Fellows, trainees and international medical graduates experience discrimination, bullying or sexual harassment – so what now? Expert Advisory Group releases final report
- Support for med students and doctors who are more likely to have suicidal thoughts
Image 1: stockimages – freedigitalphotos.net
Image 2: stockimages – freedigitalphotos.net