Abuse in medical school leads students to leave

Maccording to study Published Tuesday in JAMA Pediatrics.

Previous studies have linked discriminatory treatment in medical school to Burnt And the depression Among the students. The new paper is the first to link discrimination to a decline in medical schools, according to the authors, and it may be one reason for the number of students from many racial and ethnic groups not underrepresented in medicine. has refused In recent decades though, efforts have been made to diversify the medical school classes and the profession in general.

The study included nearly 20,000 students who began medical school in 2014 and 2015 who completed a survey conducted by the Association of American Colleges of Medicine (AAMC) for second-year medical students. were asked about instances of abuse and discrimination by faculty, staff, and other students, including public humiliation, physical harm, threats, or denial of opportunity; receiving lower grades or ratings; or subject to offensive remarks based on race, ethnicity, or gender.


The study compared these reports to students’ attrition rates and found that those who reported no attrition rates had 1.2% attrition rates, while students who reported repeat (two or more experiences) of abuse had 4.1% attrition rates. Students who reported repeated experiences of discrimination had attrition rates of 1.9% compared to 1.3% for students who did not report any discrimination.

Abuse and discrimination led to high attrition rates for all sexes, genders, and races, with the exception of Asian students, whose attrition rates were among the lowest. The study found the highest rates of attrition in students from underrepresented groups who reported abuse or discriminatory behaviour.


The authors said their study likely underestimated true attrition rates for students of color because these students were less likely to fill out an AAMC survey and were more likely to drop out of medical school before completing two years. (In the study, underrepresented groups included students who were Black, Hispanic, Native American, Alaska Native, Hawaiian, and Pacific Islander.)

“The discovery was not surprising to me, frankly, based on what I saw and heard,” said the study’s lead author, Mytien Nguyen, a Vietnamese and Black MD-Ph.D. A medical student at Yale University, he is a first-generation American from a low-income family. Nguyen said she was excited to conduct the study to determine why she saw so many students of color in her group leaving medical school or taking leave of absence. The abuse and discrimination, she said, “make the problem even worse when you really ask ‘Is the drug right for me?'” “

Many leaders in medicine are striving to make the profession more representative of a nation’s demographics, in part because studies show that people seen by doctors who look like them often have Better health results. This new study suggests that the focus on diversification of medical school enrollment may be too limited for an approach to address the persistent lack of diversity within medicine.

“We think there is an emphasis on recruiting diverse individuals and less interest in the learning environment,” said Dwayne Powright, M.D., associate professor of black emergency medicine at Yale University and senior author of the study. Powright said medical schools need much better and faster systems for collecting data on abuse and discrimination from students and providing that data to medical school faculty so they can learn from it and improve their behavior.

“We are not trying to eliminate people,” he said. “It’s like quality improvement procedures in a hospital. When something goes wrong, we want to better understand what happened so that people can grow.”

A study co-authored by Powright and published last year found that the majority of medical students from marginalized groups reported this Experiencing microagressions At least once a week and that these incidents are related to both depression and thoughts of dropping out of medical school.

Rather than blaming the dearth of medical students of color for social problems such as early childhood education or poverty, Poetraite said medical schools need to address what they can to maintain their students’ support, enrollment and success. “Looking downstream,” he said, “the medical establishment can lay the blame elsewhere without having to fix the problems in their own home.”

Jeffrey Young, who directs an initiative to transform the healthcare workforce at AAMC, said his organization is working with medical schools across the country to make learning environments not only diverse, but also comprehensive and equitable for all students.

“Not only do we have to address the limited paths of those who have historically been excluded from medicine,” he said, “but we also have to address, when they reach our doors, what issues might prevent them from thriving?”

He said medical schools should work to better understand the experiences and struggles of historically excluded students, support these students “from day one,” and ensure that all students have a way to safely report abuse and discrimination to school leadership.

“If we help our most vulnerable students thrive, we expect all students to thrive,” Young said.