Men seem to bully more often than women in academic medicine

A higher proportion of men than women exhibit bullying behaviors during medical training and academic practice, and only a minority of victims report their experiences, suggests new research published in the online journal BMJ Open.

Previous studies have reported that harassment is common in medicine with potential impacts on mental health, professional interactions, and career advancement. UK NHS surveys reported that 55% of staff experienced school bullying and around a third were doctors in training. The prevalence of academic harassment in medical settings is unknown.

Therefore, a team of researchers led by Dr. Harriette Van Spall of McMaster University in Hamilton, Canada, set out to investigate the dynamics and consequences of school bullying in academic medical settings and to identify useful interventions by reviewing the findings. existing studies.

They systematically reviewed 68 appropriate studies conducted between 1999 and February 2021 that collectively represented 82,349 consultants or participants, based in hospitals or clinics affiliated with universities or who had trained medical students, residents, or fellows.

The included studies addressed the prevalence and impact of harassing behaviors, the characteristics of perpetrators and victims, barriers and facilitators of academic harassment, or possible interventions. Most of the included studies were established in the United States and the United Kingdom.

The term “academic harassment” was described as abuse of authority that hindered the victim’s education or career in punishing behaviors that included overwork, destabilization, and isolation in academic settings.

In their review and analysis, the researchers found that among people who responded about bullying patterns in 28 studies, the most frequently described (38.2% of respondents) was undue pressure to produce work.

In addition, among the individuals in 33 studies who reported the impact of school bullying, the most common impact was psychological distress (39.1% of respondents).

Collectively, respondents identified the most common harassers as consultants (53.6% of respondents in 30 studies), followed by residents (22%) and nurses (14.9%).

Among the demographic groups, men were identified as the most frequent perpetrators (67.2% of respondents in five studies), while women were the most frequent victims (56.2% of respondents in 27 studies).

Despite being harassed, less than a third of the victims (28.9% of victims in 25 studies) reported harassment and more than half (57.5%) of those who reported formal did not have a positive result. Fear of professional impact and lack of perceived benefits were the most common reasons mentioned for not reporting harassment.

Institutional factors perpetuating harassment included hierarchical power structures, the normalization of harassment, and the lack of implementation of anti-harassment policies.

In addition to addressing the hierarchies and permissive environments that make academic harassment common, several strategies were described in 49 of the reviewed studies.

These include anti-bullying policies, education, anti-bullying oversight committees, institutional support for victims, and mandatory workshops on bullying. The strategies had different levels of success and the methods used to test these interventions in the studies were not robust.

The authors acknowledge several limitations in the surveys they analyzed, including the lack of a consistent definition of academic bullying, the variation of questions between studies, suboptimal response rates, lack of instrument validation, and bias of selection.

However, the authors ’research was broad in scope with a large and diverse cohort that included various medical specialties and countries.

They conclude: “The harassers are usually men and senior consultants, and more than half of the victims are women. The fear of reprisals, the lack of impact of the complaint and the non-implementation of anti-harassment policies are the more important barriers to tackling academic bullying. Methodologically robust trials of school bullying interventions are needed. ”