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Universal problems during residency: abuse and harassment.
Med Educ. 2009 Jul; 43(7):628-36.ME

Abstract

OBJECTIVES

Perceived abuse or harassment during residency has a negative impact on residents' health and well-being. This issue pertains not only to Western countries, but also to those in Asia. In order to launch strong international preventive measures against this problem, it is necessary to establish the generality and cultural specificity of this problem in different countries. Therefore, we investigated mistreatment among resident doctors in Japan.

METHODS

In 2007, a multi-institutional, cross-sectional survey was conducted at 37 hospitals. A total of 619 residents (409 men, 210 women) were recruited. Prevalence of mistreatment in six categories was evaluated: verbal abuse; physical abuse; academic abuse; sexual harassment; gender discrimination, and alcohol-associated harassment. In addition, alleged abusers, the emotional effects of abusive experiences, and reluctance to report the abuse to superiors were investigated. Male and female responses were statistically compared using chi-square analysis.

RESULTS

A total of 355 respondents (228 men, 127 women) returned a completed questionnaire (response rate 57.4%). Mistreatment was reported by 84.8% of respondents (n = 301). Verbal abuse was the most frequently experienced form of mistreatment (n = 256, 72.1%), followed by alcohol-associated harassment (n = 184, 51.8%). Among women, sexual harassment was also often reported (n = 74, 58.3%). Doctors were most often reported as abusers (n = 124, 34.9%), followed by patients (n = 77, 21.7%) and nurses (n = 61, 17.2%). Abuse was reported to have occurred most frequently during surgical rotations (n = 98, 27.6%), followed by rotations in departments of internal medicine (n = 76, 21.4%), emergency medicine (n = 41, 11.5%) and anaesthesia (n = 40, 11.3%). Very few respondents reported their experiences of abuse to superiors (n = 36, 12.0%). The most frequent emotional response to experiences of abuse was anger (n = 84, 41.4%).

CONCLUSIONS

Mistreatment during residency is a universal phenomenon. Deliberation on the occurrence of this universally wrong tradition in medical culture will lead to the establishment of strong preventive methods against it. Current results indicate that alcohol-associated harassment during residency is a Japanese culture-specific problem and effective preventive measures against this are also urgently required.

Authors+Show Affiliations

Department of Clinical Research and Informatics, Research Institute, International Medical Center of Japan, Shinjuku-ku, Tokyo, Japan. skobayashi-fr@umin.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19573185

Citation

Nagata-Kobayashi, Shizuko, et al. "Universal Problems During Residency: Abuse and Harassment." Medical Education, vol. 43, no. 7, 2009, pp. 628-36.
Nagata-Kobayashi S, Maeno T, Yoshizu M, et al. Universal problems during residency: abuse and harassment. Med Educ. 2009;43(7):628-36.
Nagata-Kobayashi, S., Maeno, T., Yoshizu, M., & Shimbo, T. (2009). Universal problems during residency: abuse and harassment. Medical Education, 43(7), 628-36. https://doi.org/10.1111/j.1365-2923.2009.03388.x
Nagata-Kobayashi S, et al. Universal Problems During Residency: Abuse and Harassment. Med Educ. 2009;43(7):628-36. PubMed PMID: 19573185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Universal problems during residency: abuse and harassment. AU - Nagata-Kobayashi,Shizuko, AU - Maeno,Tetsuhiro, AU - Yoshizu,Misaki, AU - Shimbo,Takuro, PY - 2009/7/4/entrez PY - 2009/7/4/pubmed PY - 2010/1/22/medline SP - 628 EP - 36 JF - Medical education JO - Med Educ VL - 43 IS - 7 N2 - OBJECTIVES: Perceived abuse or harassment during residency has a negative impact on residents' health and well-being. This issue pertains not only to Western countries, but also to those in Asia. In order to launch strong international preventive measures against this problem, it is necessary to establish the generality and cultural specificity of this problem in different countries. Therefore, we investigated mistreatment among resident doctors in Japan. METHODS: In 2007, a multi-institutional, cross-sectional survey was conducted at 37 hospitals. A total of 619 residents (409 men, 210 women) were recruited. Prevalence of mistreatment in six categories was evaluated: verbal abuse; physical abuse; academic abuse; sexual harassment; gender discrimination, and alcohol-associated harassment. In addition, alleged abusers, the emotional effects of abusive experiences, and reluctance to report the abuse to superiors were investigated. Male and female responses were statistically compared using chi-square analysis. RESULTS: A total of 355 respondents (228 men, 127 women) returned a completed questionnaire (response rate 57.4%). Mistreatment was reported by 84.8% of respondents (n = 301). Verbal abuse was the most frequently experienced form of mistreatment (n = 256, 72.1%), followed by alcohol-associated harassment (n = 184, 51.8%). Among women, sexual harassment was also often reported (n = 74, 58.3%). Doctors were most often reported as abusers (n = 124, 34.9%), followed by patients (n = 77, 21.7%) and nurses (n = 61, 17.2%). Abuse was reported to have occurred most frequently during surgical rotations (n = 98, 27.6%), followed by rotations in departments of internal medicine (n = 76, 21.4%), emergency medicine (n = 41, 11.5%) and anaesthesia (n = 40, 11.3%). Very few respondents reported their experiences of abuse to superiors (n = 36, 12.0%). The most frequent emotional response to experiences of abuse was anger (n = 84, 41.4%). CONCLUSIONS: Mistreatment during residency is a universal phenomenon. Deliberation on the occurrence of this universally wrong tradition in medical culture will lead to the establishment of strong preventive methods against it. Current results indicate that alcohol-associated harassment during residency is a Japanese culture-specific problem and effective preventive measures against this are also urgently required. SN - 1365-2923 UR - https://www.unboundmedicine.com/medline/citation/19573185/Universal_problems_during_residency:_abuse_and_harassment_ L2 - https://doi.org/10.1111/j.1365-2923.2009.03388.x DB - PRIME DP - Unbound Medicine ER -