'Being Sick a Lot, Often on Each Other': Students' Alcohol-Related Provocation

Med Educ. 2014 Mar;48(3):268-79. doi: 10.1111/medu.12300.


Context: Many medical students consume alcohol in excess, which can compromise their professionalism and increase their risk of future alcohol dependency. Just one study in Japan has examined the social influences of alcohol consumption among medical students. Eighty-six per cent (n = 821) of their respondents reported experiencing some form of alcohol-related harassment since the beginning of medical school. No similar research has been conducted in the UK.

Methods: A cross-sectional online questionnaire of medical students at three British medical schools. In total, 216 students answered questions regarding their experiences of alcohol-related provocation (as targets and instigators), the rate of occurrence of events and their distress following acts of provocation. An open-ended question enabled respondents to report personal experiences of alcohol-related provocation.

Results: Seventy-five per cent (n = 162) of respondents reported experiencing alcohol-related provocation during the past year, with 49.1% (n = 106) reporting instigating acts of provocation. The most prevalent experience (both for targets and instigators) was coercion to drink an entire alcoholic beverage at once as part of a game. Most acts of alcohol-related provocation generated little or no distress. Males were significantly more likely to experience some events than females. Thirty-two personal narratives of alcohol-related provocation were reported (only three reported resisting provocation). Thematic analysis identified three themes with differing power relations: ongoing 'peer-peer provocation' as a commonplace social activity, hierarchical 'peer provocation' at initiation ceremonies and 'team-mate provocation' at sports socials as bonding exercises. The tone of the narratives depended on the context in which the events described occurred.

Conclusions: Alcohol-related provocation occurs among some UK medical students and may present professionalism issues to medical students. Medical schools may wish to integrate more teaching regarding behaviour around alcohol into their curricula by addressing students' explicit and implicit attitudes towards alcohol consumption.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / psychology
  • Binge Drinking / complications
  • Binge Drinking / epidemiology*
  • Binge Drinking / psychology
  • Coercion*
  • Cross-Sectional Studies
  • Curriculum
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Peer Group
  • Qualitative Research
  • Schools, Medical / statistics & numerical data*
  • Students, Medical / psychology
  • Students, Medical / statistics & numerical data*
  • Surveys and Questionnaires
  • United Kingdom / epidemiology
  • Vomiting / chemically induced
  • Vomiting / epidemiology
  • Young Adult