Family medicine graduates' perceptions of intimidation, harassment, and discrimination during residency training

BMC Med Educ. 2011 Oct 24;11:88. doi: 10.1186/1472-6920-11-88.


Background: Despite there being considerable literature documenting learner distress and perceptions of mistreatment in medical education settings, these concerns have not been explored in-depth in Canadian family medicine residency programs. The purpose of the study was to examine intimidation, harassment and/or discrimination (IHD) as reported by Alberta family medicine graduates during their two-year residency program.

Methods: A retrospective questionnaire survey was conducted of all (n = 377) family medicine graduates from the University of Alberta and University of Calgary who completed residency training during 2001-2005. The frequency, type, source, and perceived basis of IHD were examined by gender, age, and Canadian vs international medical graduate. Descriptive data analysis (frequency, crosstabs), Chi-square, Fisher's Exact test, analysis of variance, and logistic regression were used as appropriate.

Results: Of 377 graduates, 242 (64.2%) responded to the survey, with 44.7% reporting they had experienced IHD while a resident. The most frequent type of IHD experienced was in the form of inappropriate verbal comments (94.3%), followed by work as punishment (27.6%). The main sources of IHD were specialist physicians (77.1%), hospital nurses (54.3%), specialty residents (45.7%), and patients (35.2%). The primary basis for IHD was perceived to be gender (26.7%), followed by ethnicity (16.2%), and culture (9.5%). A significantly greater proportion of males (38.6%) than females (20.0%) experienced IHD in the form of work as punishment. While a similar proportion of Canadian (46.1%) and international medical graduates (IMGs) (41.0%) experienced IHD, a significantly greater proportion of IMGs perceived ethnicity, culture, or language to be the basis of IHD.

Conclusions: Perceptions of IHD are prevalent among family medicine graduates. Residency programs should explicitly recognize and robustly address all IHD concerns.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alberta
  • Analysis of Variance
  • Data Collection
  • Education, Medical, Graduate*
  • Family Practice / education*
  • Female
  • Humans
  • Internship and Residency*
  • Male
  • Pilot Projects
  • Prejudice*
  • Prevalence
  • Retrospective Studies
  • Social Behavior*
  • Social Perception*
  • Surveys and Questionnaires