[Experiences of bullying in medical residents]

BACKGROUND

Harassment and abuse are forms of persistent intimidating behavior against a person and in medical practice those are accepted and justified at all levels of education and are considered specific to the hospital culture.

OBJECTIVE

To identify the frequency of harassment and some factors related to its existence on residents of medical specialties in Mexico City.

METHOD

A linear study was carried out in which a total of 260 interns pertaining to the following medical specialties: surgery, internal medicine, gynecology and obstetrics, and pediatrics participated. The study took place in three general hospitals in Mexico City. Two evaluations with Leymann Inventory of Psychological-Terrorization (LIPT-60) with 6 months between assessments were performed.

RESULTS

Comparison between the first and second evaluations did not show differences in any of the harassment measurements obtained. Of all residents, 265 (98.5%) claimed to have experienced some type of harassing behavior against them at least once during the previous 6 months, with a 1.4 (±0.5) average intensity, showing no difference between men and women. Women received a higher grade than men on the communication block scale. Harassing behaviors that obtained the highest average values were evident intimidation and occupational discredit. Among all harassment measurements, the specialty of gynecology and obstetrics showed the highest grade. The hospital influenced the reported harassment.

CONCLUSIONS

The most common harassing behaviors were occupational discredit, verbal threats, shouting, and mockery. The high frequency of harassment that medical residents experience during their hospital training deserves our attention.

The role of minimal invasive surgery in surgical education

The first laparoscopic cholecystectomy carried out in 1985 generated a great enthusiasm about the new surgical technique; however, it was evident that educational techniques required improvement because this new procedure presented a higher prevalence of injuries in the biliary tract than conventional surgery. Minimally invasive surgery has a number of advantages over open surgery. Some of these advantages allowed the use of technology in order to generate experts, evaluate them objectively, document the process in video, assess their competence and use simulators to improve overall surgical education.