This policy on mistreatment reflects DGSOM’s commitment to maintaining an environment where there is mutual respect between students, teachers, peers, patients, and all members of the education and health care teams. This policy provides definitions and examples of mistreatment, procedures and avenues for reporting, and information about what happens when an incident is reported.
II. Medical Student Mistreatment—Definitions and Examples
The Association of American Medical Colleges defines mistreatment as behavior that shows disrespect for the dignity of others and unreasonably interferes with the learning process. It can take many forms, and includes any behavior that humiliates, degrades, demeans, intimidates, or threatens an individual or a group. To violate this policy, the behavior should be such that a reasonable person would find that it creates inhospitable working or learning conditions.
Mistreatment can be defined, but is not limited to the following domains:
Any behavior that involves physical harm, threat of physical harm or imposition of physical punishment.
Includes spoken, written, visual, or nonverbal actions directed at another person that are outside the range of commonly accepted expressions of disagreement, disapproval, or critique in an academic culture and professional setting that respects free expression.
Includes any abuse of authority or inappropriate actions, threats or retaliation in the exercise of authority, supervision, or guidance. This includes using learner evaluation, grades and potential letters of recommendation as quid pro quo for behaviors.
Any malicious behavior that results in psychological pain and suffering.
Sexual harassment is defined as unwelcome sexual advances, unwelcome requests for sexual favors, and other verbal, nonverbal, or physical conduct of a sexual nature when a person's submission to such conduct is implicitly or explicitly made the basis for employment decisions, academic evaluation, grades or advancement, or other decisions affecting participation in a University program (quid pro quo), or when such conduct creates a hostile working environment
Any prejudicial treatment on the basis of race, color, national origin, religion, sex, gender, gender expression, gender identity, gender transition status, pregnancy, physical or mental disability, medical condition (cancer-related or genetic characteristics), genetic information (including family medical history), ancestry, marital status, age, sexual orientation, citizenship, or service in the uniformed services, including protected veterans.
A surgeon tells the student not to take the retractor from them unless they ask the student to retract.
Scrub tech hits the student’s arm with a clamp as they are trying to sew because they did not like how the student bumped the Mayo stand.
The student is yelled at to "get out of the way" by a member of the code team as a patient is about to be shocked during resuscitation.
A resident yells at the student for “always getting in the way.”
An operating room nurse tells the student that they contaminated their gown, and instructs them to rescrub.
A resident makes fun of the student calling them “incompetent” because they do not know how to insert a Foley catheter.
An attending gives the student feedback on how to improve their performance and it makes the student feel bad because they feel criticized and not appreciated for their efforts.
An attending speaks to the student in public or private in a way with intention to humiliate, “Did you even go to college?” “How did you pass your other rotations?”
The student is in the operating room for the first time and feels timid because they do not know where to stand and what to do.
An attending tells the student not to scrub in on any cases, and says to the other members of the team, “Students always contaminate the field.”
The student who, after being given clear expectations at the beginning of their obstetrics and gynecology rotation, is asked to leave the operating room because they did not introduce themselves to the patient, read about the patient or prepare for the case.
A resident tells a student that it is their job to write all of the consult notes and progress notes for all patients on the service.
The student stays in the outpatient clinic late because there are patients that still have not been seen and labs to be followed up on.
The student is expected to work over 80 hours a week, and it is communicated to them that this will be the way to earn an Honors grade on the rotation.
The student is asked to run down to central supplies to get the necessary equipment to perform a bedside paracentesis.
The student is asked to pick up an attending’s dry cleaning or dinner for the chief resident.
A resident tells a student that they would like them to review and present a topic to the team as a way to demonstrate their knowledge base and oral presentation skills.
The student is threatened with a failing or lower grade if they do not help the resident write notes.
The student is assigned duties to help the team provide patient care that do not seem educational to the student (“scut”), including calling an outside hospital to obtain microbiology reports.
The student is assigned duties as punishment rather than education.
On the first day of third year, a resident says to the student on rotation, “You must be the newbies on service,” then offers to help the students find a computer station.
Students on the team are all given nicknames by the chief resident that are demeaning and culturally inappropriate.
The student’s question is not answered because the attending is concentrating on a critical portion of the procedure.
The student’s questions are repeatedly ignored by the attending when other learners’ questions are answered.
The student had to eat lunch alone because the rest of the team was busy with other duties.
The entire team eats lunch together every day but it is made clear that the student is not invited, and is laughed at or ignored when they enter the room.
The student working with a department chair says he feels nervous about rounding with him/her since the they can "make or break" their career.
Resident tells a student that it is their goal to make them cry before the rotation is over.
A resident incorrectly tells the student the patient’s CXR is normal and when the student reports the result on rounds the attending, who knows otherwise, gets angry at the student.
A resident purposely gives a student misinformation before rounds. Student then overhears the resident laughing with another resident about messing him over.
A male student is asked not to go into a room because a female patient only wants a female to examine her.
A student is asked by the resident on the team to attend a farewell party at a local bar for the interns leaving the service.
The student is subjected to offensive sexist remarks or name calling while on call with the team.
A student is asked by a resident to go out after hours to a bar “so they can discuss the student’s progress on the clerkship”
The student is asked to see a specific patient in clinic because they speak their language.
The student is subjected to racist or ethnically offensive remarks or names about themselves or others, including patients.
The student is asked to wear a white coat in clinic and make sure their attire meets professional standards.
The student is subjected to derogatory remarks about their or another’s sexual orientation.
III. Options After Experiencing Mistreatment:
Concern about potential violations of the DGSOM Policy on Medical Student Mistreatment may be handled by communication with various individuals, and students are strongly encouraged to formally report infractions. Options include, but are not are limited to the following:
Please note that University employees are mandated reporters and are required to inform the appropriate offices if they become aware that a student may have experienced conduct prohibited by the UC Sexual Violence and Sexual Harassment Policy or by the UC Nondiscrimination Policy Statement.
Students should also be aware of confidential resources available to them including:
IV. DGSOM Response and Mechanisms for Investigating Reports of Mistreatment:
Potential Ad Hoc Members:
Approved by MEC June 2019