Many Medical Schools Lack Safeguards to Address, Prevent Faculty Bullying

Only a handful of the top-ranked medical schools in the U.S. have established anti-bullying policies with reporting procedures for faculty, a cross-sectional study showed.

Among 91 of the top medical schools for research and primary care, only four schools had such policies. Sixty of the remaining schools had anti-harassment policies, 10 of which referenced bullying and included reporting procedures, reported Maya Iyer, MD, MEd, of Nationwide Children’s Hospital in Columbus, Ohio, and colleagues in JAMA Network Open.

None of the schools met all the “criteria for comprehensiveness” as defined by the American Medical Association (AMA), they noted.

“Without clear anti-bullying policies, the identification of bullying behaviors is ambiguous, reporting is low-to-absent, and bullies have nonstandardized repercussions,” Iyer and team wrote. “This signals a culture tolerant of bullying and an environment in which bullying can be perpetuated.”

Importantly, 26 of the schools lacked both anti-bullying and anti-harassment policies. Five schools’ policies were blocked by a log-in requirement, and one school’s website had a broken webpage.

While the Accreditation Council of Graduate Medical Education (ACGME) has established anti-bullying policies for medical trainees, no standardized policies exist for practicing physicians; therefore, any response to such behavior depends on the individual institution.

“The focus of this paper is on faculty, not students. While the literature is ripe with studies on trainee mistreatment, faculty members also experience bullying and unfortunately are not protected under the ACGME guidelines. As such, institutions must develop and implement comprehensive policies to address bullying,” Iyer told MedPage Today.

Iyer and colleagues noted that bullying “occurs in the medical setting when a power differential allows offenders to consciously target individuals through persistent negative actions to impede the education or career of the target.”

While anti-harassment policies, which are “designed to support protected class individuals,” are important, “targets of bullying may not meet protected class criteria,” leaving them with little protection, they added.

“This underscores the importance of policies with specific language naming and defining bullying, clear roles and responsibilities for faculty and administrators, and consequences for violators,” they continued.

For this study, Iyer and team included a random sampling of schools from U.S. News and World Report‘s top medical schools and created three cohorts: the top 25 schools from research and primary care rankings, 25 schools that were randomly selected from the research rankings, and 25 schools randomly selected from the primary care rankings.

They reviewed each school’s website, conducted a search of its policies, and categorized them by the presence of the following:

• Anti-bullying policies
• Anti-harassment policies mentioning bullying
• Anti-harassment policies without mentioning bullying
• No policies for either

They further assessed the comprehensiveness of these policies, by determining whether the policy “includes faculty members, describes institution’s commitment to providing a safe and healthy workplace, defines bullying (expected and prohibited behaviors), discusses roles and responsibilities for employees, outlines steps to take when experiencing bullying, provides confidential reporting procedures, prohibits retaliation and ensures privacy and confidentiality, and documents training requirements, per criteria provided by the AMA.”

Iyer and colleagues noted that not all U.S. medical schools were included, which was a limitation to their study.