‘In my specialty, staff always treat each other with respect’: truth or fiction?

Introduction

Bullying and harassment have wide-ranging effects and harm both doctors and patients.¹ In 2019, 14% of physician higher specialty trainees reported being bullied or harassed; in 2020, 31% reported feeling undermined at work within the last year.² Within one physician specialty, cardiology, repeated surveys showed 11% of trainees reporting bullying within the preceding 4 weeks.³ Significant exploration within other physician specialties is limited and major census data isn't routinely broken down by specialty. In the author's experience and discussions on the topic, there is a belief from many that bullying isn't a problem in their specialty.

For this study, we attempted to explore the difference in reported rates of bullying between specialties. The closest question from a major survey with explorable data was from the General Medical Council's (GMC's) National Training Survey, which contained the statement, to which respondents were asked to agree or disagree: ‘staff, including doctors in training, always treat each other with respect.’⁴ In this study, we present the results of this question for physician specialties.

Methods

In May 2021, responses to the identified question from the GMC's 2019 National Training Survey were manually extracted by specialty from their online reporting tool.

A 100% stacked column chart was created using Google Sheets. The GMC don't release the exact number of respondents to each question and so descriptive statistics were calculated (also using Google Sheets) on the specialty level data, weighting each specialty equally.

Results

82% (range 67–94; interquartile range (IQR) 77–87) of trainees agreed or strongly agreed with the statement ‘staff, including doctors in training, always treat each other with respect’. 6% (range 0–20; IQR 3–8) disagreed or strongly disagreed with the statement. The breakdown by specialty is shown in Fig 1.

Fig 1.

Percentage of trainees by specialty and their strength of agreement with the statement ‘Staff, including doctors in training, always treat each other with respect.’

Discussion

This study shows that very few specialties stand out, either positively or negatively, with regards to staff treating each other with respect. The possible perception that bullying isn't a problem for many specialties doesn't appear to be true. Cardiology, who've acknowledged they have a bullying problem, had 8% of respondents disagreeing with the statement, similar to other large specialties that haven't so obviously acknowledged they have a problem. Acute medicine and gastroenterology had 9%, endocrinology and diabetes, geriatric medicine, renal and respiratory medicine also had 8%. A few, often small, specialties do stand out positively, and notably palliative medicine only had 2% disagreeing with the statement.

The main strengths of this study are based upon the dataset: a high response rate with good anonymity for questions like this. The main weakness is probably around the perception of (instead of actual) anonymity.

Further work could either look at deeper analysis or implementation of guidance (such as that from the BMA) on addressing topics such as bullying and harassment.⁵