Mistreatment: College of Medicine
An environment that optimizes learning and is built on respect and dignity is our expectation. The way we treat other (faculty, students, residents, staff) either realizes this expectation or it interferes with the learning process. Discrimination, humiliation and harassment simply can't be tolerated.
AAMC Definition of Mistreatment
The Association of American Medical Colleges (AAMC) identifies eight general areas of student mistreatment:
- Public belittlement or humiliation
- Threats of physical harm or actual physical punishment
- Requirements to perform personal services, such as shopping
- Being subjected to unwanted sexual advances
- Being asked for sexual favors in exchange for grades
- Being denied opportunities for training because of gender, race/ethnicity or sexual orientation
- Being subjected to offensive remarks/names directed at you based on gender, race/ethnicity or sexual orientation
- Receiving lower grades or evaluation based on gender, race/ethnicity or sexual orientation
Occasionally, students experience mistreatment. The source of the problem can be someone in the student's social circle or family, or a professional contact. At academic health centers mistreatment in a professional context occurs infrequently in the pre-clinical portion of training programs. It is much more likely to occur in a clinical setting. In surveys conducted here and at other academic health centers, the most common kind of perceived abuse reported was "scutwork", i.e., running errands that had little educational value.
However, sometimes students were harassed more directly. This was usually verbal; they felt they were subjected to underserved public humiliation. Some examples were more serious. Students were pressured to carry out procedures in an unsafe or unprofessional way (e.g., dealing with blood without gloves). Occasionally students had to fend off romantic advances from people who held some control over the student's grade. Students sometimes found themselves witnesses to the unethical treatment of patients, incidents they felt they should report, but dared not out of concern for their evaluation.
A consistent finding nationwide is that 4/5 incidents go unreported. Students fear reprisal, do not know how to report the abuse, or are unwilling to trigger a mountainous legal response to a modest event. In response to this failure of the corrective process, Upstate has initiated a reporting procedure with two features. It provides the student immediate, widely available, comfortable access to a listener. Secondly, the student maintains control of the degree of anonymity and the level of corrective response that will result from his/her compliant.
A student is encouraged to bring complaints of mistreatment to any one of the several people; his/her faculty advisor, the counseling service, the course director, the department chair, the Deans in the College, or the Dean of Student Affairs. By indicating simply that his/her business is "of a serious nature", the student's request for an appointment will be given immediate consideration.
Initially, the listener just listens. In most cases, the student does not require immediate personal redress from the situation, but believes the behavior is wrong and should be changed in the future. The student may simply want to discuss the issues with a neutral party in the process of working out his/her own response to the problem. In this case, there is no promise to fix the situation, but only to provide a sounding board and guidance to help the student make choices. No one is named. It does not become part of any permanent record.
In other cases, the student may need more decisive relief or redress from the situation, or believes the behavior serious enough that the offender should be stopped from further incidents.
In either case, the listener will offer several levels of corrective response. At the lowest level nothing will happen. At the next level, the general nature of the problem and its location will be described at some later date to the Dean of the College and Dean of Student Affairs, with no party named. If there is a pattern of such problems in a department, it will be reported to the department chair or the curriculum committee. The intent is to correct the culture without naming specific a specific perpetrator.
For situations deserving a more pointed response, the listener/ counselor may suggest taking the specific problem immediately to the department chair, the Dean of Curriculum, the Dean of Student Affairs or the Dean of the College as deemed appropriate. These situations are complex and delicate, and the sensible path to redress cannot be standardized. In offering these alternatives, the counselor will describe to the student the likely outcomes of such a response as well as the degree of compromise to the student's anonymity that may result from the process.
In all cases, the level of corrective response is in the hands of the student who confidentiality at this first stage is nearly absolute1 Until the student says otherwise, the listener's role is only to help the student think through his or her concerns. During this stage of simply thinking aloud about the event, the student owns the information entirely, no matter its social or legal significance to the institution.
The intent of this policy is to detect patters of mistreatment by encouraging their report and to bring them as quickly and as sensitively as possible to the attention of those leaders in the best position to correct them.