Educating pressure resistant medicos

Michael Cook
9 Nov 2013
Reproduced with Permission

How can we ensure that doctors resist pressure to participate in unethical activities? Dr Craig Klugman, a bioethicist and medical anthropologist at DePaul University in Chicago, believes that medical students need much more training in ethics and character training. In a thoughtful post on the blog of the American Journal of Bioethics, he called for a reform of medical education.

"Medical education does not provide courses in moral courage, defying authority, or turning against the tide of one's peers. In fact, medical education encourages group think, keeping your head down and knowing your place in the hierarchy, and seeking out the approval of your peers. Medical education itself has often been accused of encouraging a culture of bullying and abuse of medical students.

"In 2012, the Association of American Medical Colleges surveyed medical students and found that 47% experienced mistreatment including public humiliation, degrading language, and abuse of power (such as being asked to run superior's personal errands). A 2012 study published in Academic Medicine found that over a 12-year period of time, a majority of students experienced mistreatment.

"That is enough time for the mistreated medical student to become the resident and even attending who mistreats her/his medical students. The bullied becomes the bully. The very traits that are ingrained into medical students through the hidden curriculum are the same ones that make them vulnerable to being used as instruments of the state to participate in torture and abuse."