Much has been made in recent years of the pervasive nature of bullying, discrimination and sexual harassment (BDSH) in the medical profession, and in particular in medical training. Some medical colleges, notably the Royal Australasian College of Surgeons, have undertaken substantial reviews, investigations and steps to address BDSH in practice. Other colleges have followed and addressed these issues both within their profession generally, and in relation to their training programs in particular. These advances are to be commended.
However, some recent reviews have confirmed that the problems identified have not yet been fully addressed, and that the prevalence of BDSH remains at relatively high levels within the medical profession.
More work needs to be done, and a special project being led by the Royal Australasian College of Medical Administrators, in conjunction with other medical colleges, is undertaking a significant program of work under the government funded “A Better Culture” project. The project hopes to develop resources and research to assist medical colleges, and the medical profession generally, to better address BDSH and improve the culture of our health organisations.
Russell Kennedy Principal, Michael Gorton AM, is a member of the advisory committee for the “A Better Culture” project.
It has been formed on the basis of research which indicates:
- 34% of medical trainees have experienced or witnessed BDSH
- 70% of those who experienced or witnessed BDSH did not report the incidents
- 20% of respondents indicated they were considering a future outside of medicine
(Source: A Better Culture (RACMA) (AHR, 28 November 2023: 47(6), 671-683)
The study recognised that appropriate processes need to be in place, based on contemporary approaches to address BDSH complaints. The quality of those policies and processes can affect the effectiveness of the college’s approach to BDSH. The study reviewed the policies of 16 medical colleges, of which 14 were identified as having BDSH policies. Using a scoring methodology developed by the authors, of the 14 colleges with BDSH policies, the scores ranged from 14 to 29 (out of a possible 32). This represents some disparity in the quality and potential effectiveness of the policies in place.
The authors concluded:
“The extensive variation in quality, content and accessibility of BDSH policies and procedures across all the colleges sabotages their potential, especially in the context of cross college reporting”.
The article did not, however, explicitly recognise or address the fact that most BDSH occurs in the context of a hospital environment, or at least specialist clinics, and other locations where trainees are employed, and where members of the colleges have an employment role. It is obvious that issues of BDSH occur in an employment environment, and the actual employer has a prominent, if not critical role in addressing BDSH, more than medical colleges may be able to do so. At law, the employer has the primary legal obligation, to address BDSH.
Colleges have more limited powers to intervene in the workplace, where they do not have a direct responsibility for all of the staff that may be involved in issues of this nature. Whilst the college may have responsibility for its trainee, it will not have the responsibility for others in the workplace, who are not connected to the college. However, there is clearly a desire and need for progressive improvement of policies addressing BDSH within the medical profession generally, and within some medical colleges in particular.
Notwithstanding these limitations it obviously good to see the progress occurring within the medical profession in addressing these important issues.
How we can help
If you have questions or require further assistance in relation to bullying, discrimination and sexual harassment in the medical profession, please contact Michael Gorton AM or a member of our Health team.
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