It is thought that this is at least in part an outcome of conservative traditional hierarchical structures and teaching methods in the medical profession which may result in a bullying cycle.
According to Field, people with Type A personality are attracted to highly educated professions such as medicine and law, both by the pride of overachievement and by the opportunities to exercise authority over others.
Personal egotism, reinforced by successes in career development and increased social status, can lead to power harassment towards vulnerable clients, colleagues and students.
[8] A review found that there were 5 main drivers of bullying and unprofessional behaviours in healthcare: 1. disempowered staff who feel undervalued; 2. harmful workplace processes and cultures (high job demands because of understaffing, for instance); 3. a lack of team cohesion and support, which can be caused by shift working; 4. reduced ability to speak up; 5. managers who lack awareness or recognition of unprofessional behaviours, and take no action.
[13] Physician Jonathan Belsey relates in an emblematic narrative published in AMA Virtual Mentor entitled Teaching By Humiliation that "however well you presented the case, somewhere along the line you would trip up and give the predatory professor his opportunity to expose your inadequacies.
Sometimes it would be your lack of medical knowledge; sometimes the question that you failed to ask the patient that would have revealed the root of the problem, or sometimes your ineptitude at eliciting the required clinical signs.
On one memorable occasion, when I had appeared to cover all the bases clinically, the professor turned to me and berated me for attending his ward round wearing a plaid shirt that was clearly inappropriate for an aspiring doctor.
"[14] Bullying can significantly decrease job satisfaction and increase job-induced stress; it also leads to low self-confidence, depression, anxiety and a desire to leave employment.
Fear of stigmatisation among medical students was the subject of a study in JAMA by Thomas Schwenk and colleagues at the University of Michigan's Department of Family Medicine, USA.
53% of medical students who reported high levels of depressive symptoms were worried that revealing their illness would be risky for their careers and 62% said asking for help would mean their coping skills were inadequate, according to the study published in September 2010.
[23] Medical students, perhaps being vulnerable because of their relatively low status in health care settings, may experience verbal abuse, humiliation and harassment (nonsexual or sexual).
These environments foster undue credit claims, coercive behavior, and a competitive atmosphere that prioritizes personal gain over collaborative and ethical conduct.
Such cultures, driven by pressures to publish and secure funding, undermine the well-being and professional development of junior researchers, perpetuating a cycle of mistreatment and ethical compromise.
[33] The farewell interview from Sir Ian Kennedy (Chair of the Healthcare Commission) caused significant media interest following his statement that bullying is a 'corrosive' problem that the NHS must address.