Bullying Leads to Resident Burnout
A 2016 JAMA survey of internal medicine students found that 1 in 7 respondents experienced repeated harassment by an individual with greater power, also known as bullying. Becker’s Hospital Review provided further analysis of self-reported data by these medical residents:
Verbal harassment was the most common form of bullying.
Of those who reported experiencing bullying, 31 percent sought help.
Bullying increased burnout for 57 percent of respondents.
Bullying reduced resident performance for 39 percent of respondents.
Bullying increased depression for 27 percent of respondents.
Residents who were non-native English speakers, international medical students or scored lower on the exam were more likely to report being bullied.
Each of these findings is certainly cause for concern. But, what is perhaps most alarming is that nearly 6 in 10 respondents reporting repeated harassment experienced burnout.
While these statistics would be concerning at any time in the history of formal residencies, they are particularly worrisome as we struggle to return joy to the medical profession. These days, doctors must face a variety of new challenges ranging from mounting administrative responsibilities to greater emotional isolation. Bullying inevitably adds to the stress that exacerbates physician burnout.
The consequences are very real, and they are serious. Burnout threatens physician health and endangers patients entrusted to a doctor’s care. Medical residents, already understandably anxious as novice physicians with so much to learn, should not be forced to deal with bullying, too.
One question that arises for me is whether the non-trivial percentage of residents reporting bullying is related to persistence of the old mindset that residency is a combination of an apprenticeship and a fraternity hazing. If this is the case, then we might see that over the next several years, there would be a decline in rates of bullying due to a change in policies around residencies.
In 2003, the ACGME pushed for limited resident work hours, primarily for patient safety reasons. However, over the past 15 years, the focus of polices around resident work hours has been on improving the well-being of residents and consistent with a growing view that residents are learners first and service providers second.
There is the hope that perspective of faculty who trained as residents over the past 15 years has been shaped by these policies and as a consequence could result in less bullying of residents by those in power.