Strategies for medical students who face harassment during training

Recently, a friend asked me for advice regarding how to help her daughter, a medical student who was distressed after being showered with invectives by a doctor during one of her first clinical rotations.

Unfortunately, 50% of medical students report being subjected to some kind of verbal or physical abuse during training. A recent study of university surgeons showed harassment continued long after medical school and was a contributing factor to suicidal ideation (BMC Psychol. 2014;2:53). I experienced persistent verbal abuse during my own training many years ago. So I told my story to my friend in the hope it would help her daughter as she moves through the challenges of medical training.

I’ll call my abuser “Dr. Evil.” At the beginning of clinical rotations during my third year of medical school, I first met Dr. E on rounds early on a Monday morning. I noticed the resident and intern were shifting restlessly until Dr. E showed up; at that point they stood stock still. It reminded me of small animals encountering a bear and freezing in fear, knowing that one wrong move could make them a festive meal. Dr. E seemed harmless enough. What was there to be afraid of?

The second day of rotation, Dr. E, the intern, the resident, and I were in the hallway outside a patient’s room when Dr. E asked me to present a history of the patient. He proceeded to interrupt every other word that came out of my mouth. He had a voice that was smooth and full and mellifluous as he berated me; the experience was simply terrifying.

Nevertheless, I completed the presentation. When I was done, he told me it was the worst presentation he had ever heard. A string of invectives followed, but I stopped hearing them at a certain point as can happen with traumatic events. Now clearly, there are worse traumas in life than being berated by an arrogant doctor, but in my fledgling medical student mind, I had failed.

Worse yet, tears started to run down my face. I was humiliated, sniffling as doctors and nurses walked by seemingly unfazed as they had probably seen it all before.

On rounds that day, I continued bleary eyed, in a daze. During the next 2 weeks, the episodes of verbal abuse continued. I could do nothing right. Dr. E did not like the way I presented patients, wrote chart notes, answered questions, looked at him, or breathed.

This was not my first clinical rotation. My previous rotation had been a great experience, but now I was trapped in a circle of hell for the next 2 weeks.

I needed to find resilience. I was not Dr. E’s only emotional punching bag. I witnessed him harassing other students and staff, even taking on established physicians. I realized that Dr. E attacked anyone who showed vulnerability or doubt. I dusted off my thespian skills and put on a stony mask of confidence. I showed no emotion. I vowed never again to cry if he verbally attacked me.

The rotation ended and I thought I had escaped Dr. E’s abuses. I was wrong. Dr. E refused to pass me, and I had to come back every few weeks to present write-ups of patients on other rotations. Much later, in my third year of school, Dr. E allowed me to pass his rotation, with a low C. I complained to the dean of students. I got the usual response: “Move on. Deal with it.”

Today, as a psychiatrist in a university counseling center, I often provide care to graduate and medical students who deal with difficult advisers or professors. I share with them the lessons I learned from my experience. And I told my friend to share this message with her daughter: She is intelligent. She will survive. If she has to work with this doctor again, she should develop an emotional shield. If he often attacks her verbally or ever lays a hand on her, she needs to report him to the dean of students office. She will find that wherever she works, there may be one person who abuses power, and she will need to learn how to deal with that individual. If the situation begins to get under her skin, she may want to speak with a therapist.

My hope is that my friend’s daughter will find a profession that she loves, and that she will one day look back at this encounter as a distant memory and reminder of how far she has come. She will marvel at how she was able to move forward and keep her humanity. Should she find herself in the position of a mentor or teacher, she will treat her students with respect and end the cycle of harassment that is far too prevalent in medical settings.

Dr. Morris is a psychiatrist at the University of Florida Counseling and Wellness Center in Gainesville and has provided clinical care to University of Florida students for the last 20 years. Her areas of specialty include depression, eating disorders, and anxiety disorders.

Recently, a friend asked me for advice regarding how to help her daughter, a medical student who was distressed after being showered with invectives by a doctor during one of her first clinical rotations.

Unfortunately, 50% of medical students report being subjected to some kind of verbal or physical abuse during training. A recent study of university surgeons showed harassment continued long after medical school and was a contributing factor to suicidal ideation (BMC Psychol. 2014;2:53). I experienced persistent verbal abuse during my own training many years ago. So I told my story to my friend in the hope it would help her daughter as she moves through the challenges of medical training.

I’ll call my abuser “Dr. Evil.” At the beginning of clinical rotations during my third year of medical school, I first met Dr. E on rounds early on a Monday morning. I noticed the resident and intern were shifting restlessly until Dr. E showed up; at that point they stood stock still. It reminded me of small animals encountering a bear and freezing in fear, knowing that one wrong move could make them a festive meal. Dr. E seemed harmless enough. What was there to be afraid of?

The second day of rotation, Dr. E, the intern, the resident, and I were in the hallway outside a patient’s room when Dr. E asked me to present a history of the patient. He proceeded to interrupt every other word that came out of my mouth. He had a voice that was smooth and full and mellifluous as he berated me; the experience was simply terrifying.

Nevertheless, I completed the presentation. When I was done, he told me it was the worst presentation he had ever heard. A string of invectives followed, but I stopped hearing them at a certain point as can happen with traumatic events. Now clearly, there are worse traumas in life than being berated by an arrogant doctor, but in my fledgling medical student mind, I had failed.

Worse yet, tears started to run down my face. I was humiliated, sniffling as doctors and nurses walked by seemingly unfazed as they had probably seen it all before.

On rounds that day, I continued bleary eyed, in a daze. During the next 2 weeks, the episodes of verbal abuse continued. I could do nothing right. Dr. E did not like the way I presented patients, wrote chart notes, answered questions, looked at him, or breathed.

This was not my first clinical rotation. My previous rotation had been a great experience, but now I was trapped in a circle of hell for the next 2 weeks.

I needed to find resilience. I was not Dr. E’s only emotional punching bag. I witnessed him harassing other students and staff, even taking on established physicians. I realized that Dr. E attacked anyone who showed vulnerability or doubt. I dusted off my thespian skills and put on a stony mask of confidence. I showed no emotion. I vowed never again to cry if he verbally attacked me.

The rotation ended and I thought I had escaped Dr. E’s abuses. I was wrong. Dr. E refused to pass me, and I had to come back every few weeks to present write-ups of patients on other rotations. Much later, in my third year of school, Dr. E allowed me to pass his rotation, with a low C. I complained to the dean of students. I got the usual response: “Move on. Deal with it.”

Today, as a psychiatrist in a university counseling center, I often provide care to graduate and medical students who deal with difficult advisers or professors. I share with them the lessons I learned from my experience. And I told my friend to share this message with her daughter: She is intelligent. She will survive. If she has to work with this doctor again, she should develop an emotional shield. If he often attacks her verbally or ever lays a hand on her, she needs to report him to the dean of students office. She will find that wherever she works, there may be one person who abuses power, and she will need to learn how to deal with that individual. If the situation begins to get under her skin, she may want to speak with a therapist.

My hope is that my friend’s daughter will find a profession that she loves, and that she will one day look back at this encounter as a distant memory and reminder of how far she has come. She will marvel at how she was able to move forward and keep her humanity. Should she find herself in the position of a mentor or teacher, she will treat her students with respect and end the cycle of harassment that is far too prevalent in medical settings.

Dr. Morris is a psychiatrist at the University of Florida Counseling and Wellness Center in Gainesville and has provided clinical care to University of Florida students for the last 20 years. Her areas of specialty include depression, eating disorders, and anxiety disorders.

Recently, a friend asked me for advice regarding how to help her daughter, a medical student who was distressed after being showered with invectives by a doctor during one of her first clinical rotations.

Unfortunately, 50% of medical students report being subjected to some kind of verbal or physical abuse during training. A recent study of university surgeons showed harassment continued long after medical school and was a contributing factor to suicidal ideation (BMC Psychol. 2014;2:53). I experienced persistent verbal abuse during my own training many years ago. So I told my story to my friend in the hope it would help her daughter as she moves through the challenges of medical training.

I’ll call my abuser “Dr. Evil.” At the beginning of clinical rotations during my third year of medical school, I first met Dr. E on rounds early on a Monday morning. I noticed the resident and intern were shifting restlessly until Dr. E showed up; at that point they stood stock still. It reminded me of small animals encountering a bear and freezing in fear, knowing that one wrong move could make them a festive meal. Dr. E seemed harmless enough. What was there to be afraid of?

The second day of rotation, Dr. E, the intern, the resident, and I were in the hallway outside a patient’s room when Dr. E asked me to present a history of the patient. He proceeded to interrupt every other word that came out of my mouth. He had a voice that was smooth and full and mellifluous as he berated me; the experience was simply terrifying.

Nevertheless, I completed the presentation. When I was done, he told me it was the worst presentation he had ever heard. A string of invectives followed, but I stopped hearing them at a certain point as can happen with traumatic events. Now clearly, there are worse traumas in life than being berated by an arrogant doctor, but in my fledgling medical student mind, I had failed.

Worse yet, tears started to run down my face. I was humiliated, sniffling as doctors and nurses walked by seemingly unfazed as they had probably seen it all before.

On rounds that day, I continued bleary eyed, in a daze. During the next 2 weeks, the episodes of verbal abuse continued. I could do nothing right. Dr. E did not like the way I presented patients, wrote chart notes, answered questions, looked at him, or breathed.

This was not my first clinical rotation. My previous rotation had been a great experience, but now I was trapped in a circle of hell for the next 2 weeks.

I needed to find resilience. I was not Dr. E’s only emotional punching bag. I witnessed him harassing other students and staff, even taking on established physicians. I realized that Dr. E attacked anyone who showed vulnerability or doubt. I dusted off my thespian skills and put on a stony mask of confidence. I showed no emotion. I vowed never again to cry if he verbally attacked me.

The rotation ended and I thought I had escaped Dr. E’s abuses. I was wrong. Dr. E refused to pass me, and I had to come back every few weeks to present write-ups of patients on other rotations. Much later, in my third year of school, Dr. E allowed me to pass his rotation, with a low C. I complained to the dean of students. I got the usual response: “Move on. Deal with it.”

Today, as a psychiatrist in a university counseling center, I often provide care to graduate and medical students who deal with difficult advisers or professors. I share with them the lessons I learned from my experience. And I told my friend to share this message with her daughter: She is intelligent. She will survive. If she has to work with this doctor again, she should develop an emotional shield. If he often attacks her verbally or ever lays a hand on her, she needs to report him to the dean of students office. She will find that wherever she works, there may be one person who abuses power, and she will need to learn how to deal with that individual. If the situation begins to get under her skin, she may want to speak with a therapist.

My hope is that my friend’s daughter will find a profession that she loves, and that she will one day look back at this encounter as a distant memory and reminder of how far she has come. She will marvel at how she was able to move forward and keep her humanity. Should she find herself in the position of a mentor or teacher, she will treat her students with respect and end the cycle of harassment that is far too prevalent in medical settings.

Dr. Morris is a psychiatrist at the University of Florida Counseling and Wellness Center in Gainesville and has provided clinical care to University of Florida students for the last 20 years. Her areas of specialty include depression, eating disorders, and anxiety disorders.