2018, Number 26
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Inv Ed Med 2018; 7 (26)
Perception of mistreatment during medical residency in Mexico: evaluation and bioethical analysis
Derive S, Casas MML, Obrador VGT, Villa AR, Contreras D
Language: Spanish
References: 30
Page: 35-44
PDF size: 349.81 Kb.
ABSTRACT
Introduction: Multiple interpersonal interactions are one of the many challenges faced by
medical residents. Mistreatment towards residents has been shown to interfere with their
training. However, there are few data about this phenomenon in Mexico.
Objective: To evaluate the perception of different types of mistreatment among medical residents
and to make a bioethical analysis of the results.
Method: An electronic, 107-question survey was sent to medical residents of the Mexico
State to assess their perception about psychological, physical, academic mistreatment, and
sexual abuse. Attempts were also made to identify the person responsible for the mistreatment
and its consequences. Analyses included descriptive statistics of mistreatment and its
types, as well as sociodemographic data of participants. Logistic regression was used to
assess risk factors for mistreatment.
Results: A total of 143 responses were obtained (8.2% response rate), with 84% of the residents
reported having suffered mistreatment. The most frequent type was psychological
(humiliation 78%), followed by academic (50% staying on call as a punishment and denial
of education in 40%), and physical abuse (16% were beaten, 35% were deprived of food,
and 21% were not allowed to go to the bathroom while being on call, as punishment).
Also, 21% were pressured to consume alcohol against their will. Psychological and physical
mistreatment were more frequent in surgical than medical specialties. As a result of
mistreatment, 89% of residents reported
burnout, 71% depression, 78% anxiety, and 58%
sub-optimal patient care. The main perpetrators of the mistreatment were senior residents
and attending physicians.
Conclusions: Abuse during residency is very frequent, and affects the human rights and dignity
of residents. It also reduces the learning capacity and efficiency of specialty training,
in a country with a high demand for health care that requires optimisation of economic
and human resources.
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