Most first-year physicians in training say they have experienced mistreatment -- including public humiliation by senior doctors, physical abuse and sexual harassment -- during their internships, according to a study in yesterday’s Journal of the American Medical Association (April 15). Despite the perceived mistreatment, the nearly 1,300 first-year residents surveyed were satisfied overall with their internships.

"If residents feel mistreated during their contact with their superiors, but feel that they learn from this contact, they may well discount the short-term negatives of the experience and focus on the long-term benefits of the education they receive," said the study by researchers at the Rush Primary Care Institute and Rush Medical College in Chicago.

Ninety-three percent of the residents reported experiencing at least one incident of perceived mistreatment. "Of the specific types reported, the highest percentage was recorded for public humiliation or belittlement. Attending faculty and residents at a higher level were mentioned most often as the source of the mistreatment," stated the report.

Among findings of the survey:

• 53 percent of residents reported that they were belittled or humiliated by senior residents.

• Being given "tasks for punishment," "being slapped, pushed, kicked or hit," and having someone 'threatening your reputation or career" were reported as occurring on three or more occasions by more than ten percent of the residents.

• 30 percent reported experiencing at least one episode of what they considered discrimination or sexual harassment, while 63 percent of female residents reported such incidents.

• 45 percent of residents reported observing someone falsifying medical records.

• 70 percent of residents reported observing a colleague working in an impaired condition. Lack of sleep was the leading cause (56.9 percent).

• 10 percent of residents indicated sleep deprivation was an almost daily occurrence.

• Residents reported a moderate level of satisfaction with their internship, with an average rating of 4.56 (good) on a scale of one (poor) to seven (excellent).

• Residents reported the highest contribution to their learning came from other residents, with special patients ranked second.

See JAMA press release.

1st appeared 4/16/98

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