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Medical Student Abuse

Medical Student Abuse: Incidence, Severity, and Significance

(JAMA. 1990;263:527-532)

46.4% had been abused at some time while in medical school

80.6% of Seniors reporting being abused by the senior year

69.1% of abused reported " at least one episode was "major importance and very upsetting”

49.6% indicated the most serious episode affected them adversely for a month or more

16.2% - it would "always affect them."

Reflecting on my journey from burnout, while researching Wounds of a Woman Healer, I am stopped by the degree of abuse we have endured in our medical school training. Much of it occurred before we had any experience of what it was to even have a job, entering naïve and unprepared into a complex work environment as students.

” My first surgical clerkship, 3rd year of medical school , I thought I won the medical student lottery. I was getting away from the inner city hospital of Kings County and onto cushy Staten Island, which meant free food and private patients. Privates were code for medical students to stay away. Your job was to carry out the orders of the Attending, your only boss and sole source of your final grade. So when the Attending ordered me to dissect a man's saphenous vein, solo, while he was up at the heart doing his bypass thing, I already knew I could not say no and was in way in over my head . I had zero prior surgical experience, unless you factor in suture tying practice on a chicken cutlet. No one listened or seemed to care when I said, “I never did this, and Was that okay? “ ”Sure” he said, "now's the time to learn”. What he was asking me to do was to dissect out a vein in the leg which meant you needed meticulous technique, had to tie off every feeder or else it would ooze and bleed. I didn't know how to do this . Should I know this by now? My inner critic questioned . During all this, the surgeon is tossing back instruments at the OR nurse and around the room. He didn’t like this straight DeBakey, give him the XO?!$%#^& curved one. Carrying on and on, I remember him screaming at the nurses, as they endured his full-blown tantrum. I thought maybe he was on drugs but no one said a word. I already knew what happened when one spoke up, so I was clear, this medical student does not speak at times like this, and that was that. As expected, I couldn't dissect the vein, and I remember he laughed as I panicked, and shrieked, as blood covered my dissection field. He strolled around and swooped in to fix the bleeder. What a hero“

Stories like this are sadly common, many of which may be plaguing my Generation X colleagues. As a coach I’m distinguishing we have two real choices for our progress, remove what's in the way or create something new. Come get in the Conversation and together we can get to it! #Endphysicianburnout . Grab some time on our calendar and come share your stories with us GrooveMD

Jennifer Tam, MD

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