Bullying and sexual harassment of junior doctors in New South Wales, Australia: rate and reporting outcomes
Anthony Llewellyn A B F , Aspasia Karageorge B C , Louise Nash B C , Wenlong Li B D and Dennis Neuen EA University of Newcastle School of Medicine and Public Health, Mater Hospital, Waratah, NSW 2298, Australia.
B Health Education and Training Institute of NSW, Locked Bag 5022, Gladesville, NSW 1675, Australia. Email: weli3785@uni.sydney.edu.au
C Brain and Mind Centre, University of Sydney, Level 5, 94 Mallett Street, Camperdown, NSW 2050, Australia. Email: louise.nash@sydney.edu.au; aspasia.karageorge@sydney.edu.au
D Concord Repatriation General Hospital, Hospital Rd, Concord, NSW 2139, Australia.
E Wagga Wagga Rural Clinical School, University of Notre Dame Australia, PO Box 5050, Wagga Wagga, NSW 2650, Australia. Email: dennisrnguyen@outlook.com
F Corresponding author. Email: anthony.llewellyn@newcastle.edu.au
Australian Health Review 43(3) 328-334 https://doi.org/10.1071/AH17224
Submitted: 25 September 2017 Accepted: 11 December 2017 Published: 16 February 2018
Journal Compilation © AHHA 2019 Open Access CC BY-NC-ND
Abstract
Objective The aim of this study was to describe rates of exposure to bullying and sexual harassment in junior doctors in first- or second-year prevocational medical training (PGY1 or PGY2 respectively) positions in New South Wales (NSW) and the Australian Capital Territory (ACT), and to explore the types of actions taken in response.
Methods A cross-sectional survey of junior doctors in PGY1 or PGY2 positions was undertaken in 2015 and 2016 (n = 374 and 440 respectively). Thematic analysis was undertaken on free-text responses to describe the reporting process and outcomes in more depth.
Results The estimated response rate was 17–20%. Results from both surveys followed almost identical trends. Most respondents in 2015 and 2016 reported being bullied (n = 203 (54.3%) and 253 (57.5%) respectively), 16–19% reported sexual harassment (n = 58 and 82 respectively) and 29% of females reported sexual harassment. Qualitative analysis elucidated reasons for not taking action in response to bullying and harassment, including workplace normalisation of these behaviours, fear of reprisal and lack of knowledge or confidence in the reporting process. For respondents who did take action, most reported ineffective or personally harmful outcomes when reporting to senior colleagues, including being dismissed or blamed, and an intention not to trust the process in the future.
Conclusions The findings suggest that interventions targeted at the level of junior doctors to improve the culture of bullying and harassment in medicine are unlikely to be helpful. Different approaches that address the problem in a more systemic way are needed, as is further research about the effectiveness of such interventions.
What is known about the topic? Bullying and sexual harassment are common workplace experiences in the medical profession.
What does this paper add? Over half the junior doctors in the present study experienced bullying and nearly one-fifth experienced sexual harassment. Junior doctors are reluctant to speak out, not only for fear of reprisal, but also because they do not believe it is worth doing so.
What are the implications for practitioners? The data confirm a systemic problem of bullying in NSW. Primarily focusing on interventions with junior doctors (e.g. resilience training) is unlikely to solve the problem. Different and multipronged approaches (e.g. raising awareness in senior colleagues and training bystanders to intervene) should be tried and studied.
Additional keywords: bullying, junior doctors, medical trainee, psychological distress, sexual harassment, wellbeing.
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