Tuesday, August 14, 2012

Physical abuse in medical education? Wow.

Pauline Chen is a surgeon and author (and a professor of surgery at UCLA?); she wrote an interesting post on the New York Times' health blog about bullying in medical school and UCLA's surveys of its students:
The school has just published the sobering results of the surveys over the last 13 years. While there appears to have been a slight drop in the numbers of students who report experiencing mistreatment, more than half of all medical students still said that they had been intimidated or physically or verbally harassed.
...U.C.L.A.’s experience is not isolated. In fact, national medical education surveys that include questions about mistreatment indicate that the environment at that school is about average. And the striking similarity of experiences across a generation of students suggests problems not just with one institution, but with the culture of medical training itself. “This is a national problem,” Ms. Fried said. “Our faculty and doctors-in-training come from all over, including schools where some of them might have been mistreated.”
I'm not going to pretend that this sort of behavior doesn't happen in chemistry. People act inappropriately and unprofessionally everywhere, unfortunately. Humans love status competition, and some people will play the game as awfully as they can get away with. What I was really surprised at was the level of physical intimidation that was happening, as mentioned in the original published study:
A cardiology fellow slapped my hand when I was unable to answer an EKG question and said: “If teaching doesn’t help you learn, then pain will.” 
I was walking (slowly apparently) in front of my intern. She was frustrated and pushed me forward with both of her hands on my shoulders, saying: “walk faster!”
Wow. That's completely out of line. I've never seen that (physical intimidation) in my time in chemistry; I'm sure the comments will produce some awful stories. (I hope not, but...)

Verbal abuse, of course, is a different story. Every intern, graduate student, postdoc, entry-level chemist, etc. has at least one stinging put down stored away in their memories. Our minds are very good at torturing ourselves with even the mildest of negative comments, however accurate or inaccurate (one reason why I think that physical intimidation is so over-the-top inappropriate.) While I've never had anyone yell at me that "You're the worst chemist I've never met!" or "I'm going to kill you" or whatever, I have my share of stories on that front. (None recently, thank God.)

Note, especially to relatively junior people: It is possible that you may encounter this sort of behavior. It is wrong! It is not your fault. Unfortunately, it may not even have anything to do with you, as a person, as opposed to your status in whatever hierarchy that you're in. An organization that puts up with that kind of behavior, especially the more severe kind, is not an organization that you want to be a part of.

It's my sincere hope that, as time goes on, that this sort of behavior (verbal abuse, physical intimidation, sexual harassment, racial comments) happens less and less in workplaces. I don't believe that verbal abuse produces better physicians and it certainly doesn't produce better chemists.

15 comments:

  1. I think one of the hardest skills to learn is how to give constructive criticism.

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  2. Shortly before I was "separated" from my last position, my supervisor compared my career at that company to a patient on life support. To say I was insulted is putting it mildly. I doubt I will forget that moment in a hurry.

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  3. http://www.smdailyjournal.com/article_preview.php?id=1752941&title=Ex-Genentech%20worker%20files%20lawsuit%20for%20firing

    Jerks everywhere.....

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  4. and to follow Unstable Isotope's comment, another learned skill is to receive criticism with the understanding that you aren't being attacked.

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    1. Agreed, taking criticism is the 2nd hardest skill.

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  5. I can imagine a rise in reports coming from a generation that's been raised to think everything confrontational is litigatable, or from the increasing percentage of female med students, who are 'threatened' by assertive behavior.

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    1. Wow, "female med students, who are 'threatened' by assertive behavior"? This is a classic "it's not sexism, it's the problem of those delicate women" retort.

      What about many generations of privileged males who sexually, verbally, physically abuse female students/underlings because of "culture" or belief that women can't cut it? Or those who feel their masculinity threatened by a powerful female?

      You can be assertive without being abusive or threatening.

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    2. What about many generations of privileged males who sucked up their own abuse because that was med school/fraternity "culture," that it was all worth it or belief that that was the way it just was?

      I'm just explaining an observation. If you've never seen such behavior then i guess it doesn't exist.

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    3. I thought the report says there's been a slight drop in reports over the past 13 years?

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    4. Yeah, you're right, i was just jumping to the conclusion that the reportage was higher now than a generation ago. If slight drop in recent memory, i guess the 'culture' has slowly changed after all.

      Although i think the second example ("walk faster"!) is more amusing than abusive myself.

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    5. Bullying behavior is never excusable and no one should put up with abuse of verbal or physical nature.
      I was the Anon who followed up Unstable Isotope's astute comment by suggesting that handling criticism is another necessary skill. I had witnessed such an incident that morning in a research meeting. The senior PI (a med doctor/prof) asked a question of a junior physician (one who has completed their residency but is about 30 yrs younger than this prof and is doing a research rotation), and the junior physician failed to fully answer the prof's question. When I discussed the instance later with the Junior, their response was "he was attacking me!". No- he was not. He was asking you why you opted to perform assay 1 over assay 2. But the Junior persisted in the belief that they were being singled out and persecuted. I have witnessed some bad behavior by senior fellows and in this instance it wasn't the senior who was out of whack.

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  6. My PhD adviser was verbally abusive to me on more than one occasion. I have not yet had anyone in the medical training abuse me in any way - but it will happen, I'm sure. There was one 4th year student who was kind of a bully, but only a little.

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  7. In all fairness, who hasn't wanted to slap the sh*t out of a snotty little med student?

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  8. Academia needs HR departments with teeth. As much as corporate HR can be a pain, they prevent industrial bosses from behaving as badly as professors often do. There's no way to discipline a professor short of outright termination, so mild abuse of a subordinate doesn't get nipped in the bud, while an industrial boss would probably get a talking-to from HR before the situation escalates.

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  9. I've experienced more verbal abuse than I care to discuss. It's rampant. Constructive criticism and harsh discussion about the actual work is one thing. I'm fine with that and have pretty thick skin when it comes to talking about my work. But insulting me, directly, because I didn't know something I should have been taught by the person insulting me, is ridiculous. And happens all the time. Department Heads and HR don't care.

    And then there's the bullying. Such as the time another graduate student and postdoc in my lab had a private meeting with the department head to get me dismissed, after they had already engaged in over a year's worth of bullying and abuse that I had already reported to my boss, the department head, and grad student advisor. His response was to tell me I should just learn to get along with them.

    Not to mention the sexual harassment. When I was working for a national government laboratory I was propositioned daily. Comments were often made about my voice, my appearance, what my social status would be in the speaker's native country, my "weekend plans" and assumed sexual preference. My boss said I need to figure it out for myself. HR told me to write everything down. That's it, write it down. And not do anything about it.

    I have seen fist-fights in the lab. And have heard one person actually beating up another in the hallway. People throwing things is not uncommon.

    Working in science is often very difficult and not because of the challenge of the job itself. In 20 years I've found competent managers are few and far between.

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