brownug

Abuse very well can lead to further abuse in some people. If a person doesn't deal with and properly heal from abuse, then they may do the same thing to others.

You see it quite a lot in studies. I'm not sure of the psychology behind it...but it's very very common that abusers were abused themselves. I don't know exactly what the logic is...maybe others do.

Also, this is NOT just common in medicine, but in almost EVERY field or social sphere of society. You see it from elementary school playground bullying to college frat hazing and sports team bullying....to bullying in the military....to bullying at low-wage unskilled labor types of jobs....all the way to graduate school and professional levels (where people are highly educated).

What I've been told is to always document document document. Sometimes you may not be able to immediately figure out a person's intentions...liek if you misheard something or misinterested something or it's a ONE time anamoly, etc. ....but if you suspect something and it's happened twice or more....then start documenting. Heck, even after the first time....maybe document. You can't always figure everything out yourself and aren't expected to frankly, lol....these people can be real socio-paths. I've heard sometimes a REALLLLLY crafty abusers will be nice to you AND abuse you so you sort of stay with them and mayhbe even feel guilty yourself as in wondering if YOU are the problem.

But regardless of whether or not something really is bully....just document and have a trusted friend or professional counselor, etc. look at what's happened from an outside perspective. Some of that behavior, in addition to being unprofessional, may even rise to the level of being criminal??...as in emotional abuse and threats? So try to have witnesses, try to document, and have people objectively look at your situation.

In the meantime, try to just focus on your work realizing in the back of your mind that you have a plan to deal with this. It's when you don't have a plan taht it's really destructive and can disturb your peace and lead to lower productivity. I worked a year at a min. wage job part-time during my first year of college.

There was a guy on my team that always bullied me. He did it in front of his friends, but didn't do it with the cool and social folks. I'm a bit on the shy side in person, so he picked on me a lot. But when the cool crowd or the more social folks were around that were not his friends, then he'd jsut keep to himself. He was like a COWARD.....going after me only when he had numbers. I mostly kept quiet adn didn't know how to deal with it. I never told my parents or anyone. I was ashamed and honeslty thought I was weak for not being able to stand up to him.

BUT, after countless times of bullying me...one night I had had enough and yelled back at him and stood up to him....he started laughing a little, but then I realllly got in his face (I wouldn't do that again...it's NOT me...but just a heat of the moment loss of control of anger....) and cursed him out really bad and he was really surprised. ...He stopped laughing and actually backed off lol....there was one other person around that he wasn't close friends with, so he had no back up. It was just us three and he said

"Hey calm down calm down man...I was just joking...C'mon man you know I was just playing..."

I DIDN'T know, nor did I believe him....I think he WAS trying to bully me....but I think he was shocked I stood up and could get that mad. He finally backed off after that and never really bullied me again. Maybe very very very rarely he'd make a subtle remark here or there, but it was never the same after that.

In hindsight, what I would ahve done rather than yell at the guy back...kind of counter-productive, lol....is to just document it and tell my boss!!! Such a simple thing to do, but at the time I was inexperienced and ashamed. It's because the way he joked me was to take things I was very self-conscious about and make fun of those things. So it would have been tough to tell others b/c I was already embarassed of those things. ...But if I could go back in time, I'd just really let someone know, b/c that's really the best way to handle things.

brownug

Let me also add...I wonder if there are different types of bullying distinctions we should make?

Ok, in my story above, the guy bullying me was not telling me off WHEN I MADE A MISTAKE. He was OUT TO GET ME...I never made fun of me for making errors on the job...well maybe he would if he was like perfect...since he made errors himself too, lol...but instead he's make fun of how I looked or my background and other characteristics personal to my identity. He purposely tried to hurt my feelings for whatever sick reason he had in his mind.

Now..with these medical doctors yelling at medical students...if it's ONLY when they mess up and the doctors don't go out of their way to pick on these students otherwise, then maybe that's different? I'm not saying they SHOULD abuse people even when the mess up...but just saying that that's different.

If you've ever watched an NBA game...there are millionaire athletes getting chewed out really bad in front of the whole nation in big games when they mess up. These coaches probably curse and may or may not call them names. ...I'm not saying at all that that's OK or the best way to go about things...but asking if it's mayyyyyyybe possssssibly just a kind of "tough love" or "tough criticism" to get a person's attention to immediately improve?

Has anyone ever watched that show "Hell's Kitchen" with that British chef who curses and yells and name calls his contestants? ...I get the sense that people actually love Gordon Ramsay and appreciate the opportunity to learn from and work with him, despite his potty mouth and temper tantrums and throwing pans and breaking dishes when he's mad. He's one of the greatest chefs in the world and in order to train up competent chefs he needs to make sure they perform up to his standards. Of course he could use OTHER techniques, but his methods do tend to be bully-like and crass and rude.

Check him out in action: Gordon Ramsay Hell's Kitchen Medley Of Insanity #1 - YouTube

I've heard some people argue that he purposely breaks people down (to humble them) ONLY to build them back up later (he has a soft side too). He wants perfection and has high standards and wants people to do better. So he uses his abrasive ways to go about it.

I wonder if tehre's maybe a bit of similarity with medical doctors or coaches...or anyone in a position of power who criticizes when people make MISTAKES.....that's the key is that they only behave this way if you make a mistake. Maybe it's a style of tough love????

Again, I"m not justifying it,b ut just maybe trying to put it into context???

MiamiDAP

The only thing that ANYBODY could do is to IGNORE and never ever take it personally. D. just got very nice group for this block and is very happy. However, she has mentioned yet another time that she is very glad that she had an opportunity to be with others who are way to tense for her taste, who tend not let people speak. It was an awesome learning experience. If you are not taking it for what it is (learning experience), than all your suffering is wasted. My own D. will never ever treat others like this, she will not go down to this level of treating people.

curmudgeon

After reading the thread again, I think there are a few points to make.

First the OP is talking about "master servant" type bullying, not peer to peer or playground bullying. Someone in a position of power over the med student. The dynamic is really much different.

Secondly, what is considered bullying or inappropriate behavior to one is not necessarily bullying to all.


Third, and probably the most important to me, these students weren't raised the same way. Their sensitivities are different. Their tolerances are different.Their learned responses and defense mechanisms are different.


I tell all parents that IME "parenting is controlled by the 'Law of Un-intended Consequences'". Wherever you push as a parent, it is gonna pop out somewhere else. Protect them from all harshness and conflict, and they may not be able to deal. Don't protect them at all, and risk "injury' that way. All we can do is use our best judgment based on the personality of our own kids. Other than that, hey. They can tell it to the shrink. We did the best we could with the then available data.

ginnyvere

I think all of us have dealt with people who treated us less than well. But there's a big difference between being treated less-than-well and being mistreated. The first is a misguided attempt to help students learn. The second is purposeless and often dangerous.

Kicking someone out of the OR when they say or do something the attending doesn't like is mortifying and tear-inducing. But students try and figure out what they did wrong (or what that particular attending thinks was wrong even if it was something that a different attending specifically wanted the student to do) so that it doesn't happen again. That's where the student has to accept that sometimes in their training they will be made to feel like abject failures through no real action on their own part.

Throwing sharp instruments in the OR is never acceptable. It won't correct behavior, it's dangerous to whoever the instrument was thrown at/in the general direction of, it disrupts everyone in the OR, and (most importantly) it's dangerous to the patient. If nothing else, it should be reported to the clerkship director, who can keep students from working with that person again. And if it's a resident that does it, the problem will be corrected.

I was lucky enough that though I was treated less than well a number of times (all of us are), I was never mistreated. I think that this is, in hindsight, the way most people feel about how they were treated as medical students.

PS: I just used surgery as an example. In my experience, the closest I ever came to frank mistreatment wasn't actually in surgery, so it's definitely not limited to one field.

Lemaitre1

@ MiamiDAP, if your daughter is distressed by percieved bullying by her own classmates during the two pre-clinical years, attendings, residents and even MS4s are going to make her life a living hell when she starts her clinical rotations. The senior residents are probably the most toxic of the bunch and can be unbelievably cruel and threatening. I think you are going to have to talk with your daughter before her rotations begin and develop some sort of strategy to cope with it. During my Surgery rotation as an MS3 I tried to return the verbal abuse in kind and on a number of occasions invited particularly abusive residents to follow me out to the parking lot and we could settle it there. When they realized I was serious, they pretty much kept their distance from me and tormented other MS3s.

Challenging abusive residents to a fight is probably not an option for your daughter but she can not allow herself to become a victim because that leads to worse victimization. There were a lot of women in my class and many were victims of bullying and one was even assaulted by a particularly wretched attending during an away rotation. However nearly all found a way of coping although it is sometimes very difficult.

curmudgeon

Again. Sounds nice.

GA2012MOM

Charming....

WayOutWestMom

See... this is where D1's years of waitressing experience comes in handy. She's perfected her techniques for dealing with a$$****s [drunk and sober] over nearly a decade. (And none of them involve spitting in their food in the kitchen before she serves it.)

DocT

"The senior residents are probably the most toxic of the bunch and can be unbelievably cruel and threatening."

My daughter in her pediatrics rotation already has had runins with one resident who kept belittling her because she wrote .6 instead of 0.6 and actually reported it to her school.

plumazul

Normally I would be sympathetic to the victims of perceived "bullying", however, error associated M&M is a real problem. The distinction between writing .6 vs. 0.6 may seem trivial, but it may very well save a life some day. I had a 10% markdown on a pchem lab report because of such an error, and I will never do it again.

DocT

and that is a good reason to say she's incompetent and report it to the Dean? How about just telling her to do this.

plumazul

^^ Who knows why people do the things they do. Perhaps the resident has already been through a bad experience related to this issue and so is now somewhat hypersensitive? We should never lose sight of the fact that the whole process is for the benefit of current and future patients, not the student per se. At the same time I would always insist on a professional demeanor from any teacher in a clinical setting.

MiamiDAP

Curm,
Very true, "Protect them from all harshness and conflict, and they may not be able to deal. Don't protect them at all, and risk "injury' that way....." - this is exactly my experience with my D. She was always told (and followed advice) to seek company of very nice people. She has developed very friendly personality this way and keeps most of her friends since she was 3 y o. It took her an effort and many talks with me (possibly others) to learn to protect her psych and not take "tense, powerful and overconfident" personalities personally. In addition, in her case it could have been conflict of cultures as there are many students with very different backgrounds. however, looking back she herself realized that sooner or later everybody has to deal with personal differences and it was a great learning experience that she was able to take positively. She did have very very hard time though all thru last block, which also happened to be the most difficult academically. Well, I know it is a cliche, but when going get tough, tough get going.....and I feel sorry for the rest.....

DocT

My perception which may be wrong is that the bullying is worse for female students particularly in surgery.