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by Internet Medical Society

Bullying of doctors in training is widespread. Abdelmageed Abdelrahman discusses the impact of the problem and how it can be tackled

In 2014, nearly 10% of doctors in training reported to the General Medical Council (GMC) that they had experienced bullying. The figures, collected as part of the GMC’s National Training Survey of the 50 000 doctors in training, reveal the extent of the problem among doctors training in the United Kingdom.

But the impact of bullying extends beyond the doctors in training who are affected, and the GMC argues that bullying and undermining affect patient safety. One way in which bullying and undermining can do this is by disrupting communication within teams. Someone who is being bullied may avoid a senior colleague instead of asking for help in a situation of clinical uncertainty. A doctor who is being bullied may also be less likely to raise concerns or report adverse events.

In light of the concerns raised by the National Training Survey, the GMC’s chief executive, Niall Dickson, stated that it was important to create a culture where bullying is not tolerated. He said that such a culture should support and encourage doctors in training, so that they feel confident to raise concerns.

Undermining or bullying a doctor in training can damage the doctor’s self-confidence at a time when the relationship with senior doctors is important and being open to feedback is essential in order to develop. Concerns about bullying and undermining must be reported and acted on, otherwise a culture will develop in which bullying is accepted.[1]

The first step in tackling bullying in the workplace is to report it, because employers are only able to address incidents of bullying that are reported. Rates of under-reporting are currently high, so confidential and informal routes for reporting bullying and undermining need to be provided so that levels of reporting can be improved.

One of the issues raised in the responses to the GMC’s survey was that there was a lack of understanding of how to report an incident of bullying.[1] The BMA’s advice on reporting bullying emphasises that it is the responsibility of the employer and the employer’s human resources team to provide a policy on bullying to all employees, and that any concerns raised should be dealt with seriously and efficiently (box).

Dealing with bullying

Diary of events

Consider writing down the incidents of bullying as they occur, including the date and time, what happened, and if anyone else was present.

Informal action

Contact the alleged bully or harasser and tell them that their actions are hurtful, and why this is so, and request that they stop behaving in this way. You may wish to ask a colleague to be present. Alternatively, if this is too difficult for the individual to do, contact your human resources department or equivalent and request a representative to speak to the alleged bully. It is important to keep a record of any action taken, even if this is informal.

Formal action

Informal action can be effective for dealing with bullying, but you may feel the need to take formal action. You can do this from the beginning if you feel that this is the most appropriate way to deal with a case of bullying. A formal written report should be sent in confidence to the human resources department or equivalent supervisor of the alleged bully and an investigation should begin.[2] Ensure that you make it clear that this is a formal complaint and give as many details as you can of the events that have taken place.

Investigation

A manager who is not directly involved in the issues being investigated should then investigate the complaint, and human resources may be involved in this process. If there are any formal meetings, you are entitled to be accompanied by a colleague or professional representative. There are generally three outcomes of an investigation, and these should be detailed in a report. These include taking no action, beginning a disciplinary hearing, or taking alternative management action.

Dissatisfaction

If you are not satisfied with the outcomes of the investigation, you have the right to raise a grievance.

Competing interests: I have read and understood BMJ’s policy on declaration of interests and have no relevant interests to declare.

References

  1. General Medical Council. National Training Survey 2014. Bullying and undermining. Jan2015.www.gmc-uk.org/education/surveys.asp.
  2. British Medical Association. Stopping harassment and bullying at work. Jan 2015.http://bma.org.uk/practical-support-at-work/doctors-well-being/bull....

From BMJ:

Sarah Brown medical student, Queen’s University, Belfast, UK 
Abdelmageed Abdelrahman trainee in obstetrics and gynaecology, Antrim Area Hospital, County Antrim 
Gary Dorman consultant in obstetrics and gynaecology Antrim Area Hospital

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