The Estrogen War: Bullying in Med Schools

[James Brody]

The obvious title for this might be "sexual selection": I'm more interested in another aspect of evolution. Estrogen and testosterone have an ongoing war and the chronology and tactics for each skirmish would fill a very long book but one that quickly becomes boring: the organization described in the first chapter also appears in the last and every one in between: only the participants vary.

Medical schools may be the next arena, after public elementary schools, wherein "female" standards are imposed on "male" conduct. Fortunately, this is a "shared environment" wherein the participants adjust to their immediate environment and leave it as quickly as possible for one more suited to their natures! While the estrogen-afflicted tend to destroy the blatantly clumsy, impulsive, poorly socialized, estrogen-challenged; the more clever of us escape, avoid, hide, defy, or use our nature-given talents to become better liars. Even Han Solo got out of the Empire's carbonite trap!

I clipped the following from Journal Watch for Psychiatry.

"Bullying Is Rife in U.S. Medical Schools"
"A new prospective study looks at harassment in U.S. medical schools, with disturbing results.
More than 2000 students, all from the class of 2003 at 16 U.S. medical schools, completed questionnaires at first-year orientation, at the beginning of their clinical rotations, and during their fourth year. The second and third surveys addressed the issues of harassment and belittlement.

By the last questionnaire, 27% of students reported having been harassed by housestaff, 21% by faculty, and 25% by patients; 71% reported having been belittled by housestaff, 63% by faculty members, and 43% by patients. Only 13% of students rated these experiences as severe. No one specialty was more likely to engage in harassment or belittling, but students going into family practice were more likely to report having been harassed or belittled. Mistreated students were significantly more likely to be stressed, to be depressed or suicidal, and to drink alcohol."
Keith I. Marton, MD Published in Journal Watch General Medicine November 21, 2006

Marton also remarks: "...it is unclear whether harassment provokes depression and alcohol use, or whether depressed or alcohol-using students have a lowered threshold for perceiving certain behaviors as harassment." (I think it's interesting that the residents in family practice were more apt to be targets. Were they also more apt to be female? Were they more apt to be empathic?

References from Marton.
Frank E et al. (2006) Experiences of belittlement and harassment and their correlates among medical students in the United States: Longitudinal survey. British Medical Journal. 333:682-4.
Wood DF (2006) Bullying and harassment in medical schools. British Medical Journal 333:664-5.