To the point: undergraduate medical education learner mistreatment issues on the learning environment in the United States

Am J Obstet Gynecol. 2019 Nov;221(5):377-382. doi: 10.1016/j.ajog.2019.04.021. Epub 2019 Apr 25.


This article, from the To the Point series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is an overview of issues to consider regarding learner mistreatment and its effects on the undergraduate medical education learning environment in the United States. National data from the American Association of Medical Colleges Graduate Questionnaire and local data regarding learner mistreatment provide evidence that the learning environment at most medical schools needs to be improved. The American Association of Medical Colleges' definition of learner mistreatment focuses on active mistreatment, but data on passive mistreatment also contribute to a negative learning environment. The lack of tolerance for active mistreatment issues such as public humiliation and sexual and racial harassment need to be made transparent through institutional and departmental policies. Additionally, reporting mechanisms at both levels need to be created and acted upon. Passive mistreatment issues such as unclear expectations and neglect can also be addressed at institutional and departmental levels through training modules and appropriate communication loops to address these concerns. To fully confront and solve this challenging issue regarding learner mistreatment at the undergraduate medical education level, solutions to need to be implemented for faculty, residents, and students in the institutional, departmental, and clerkship settings.

Keywords: learner mistreatment; learning environment.

Publication types

  • Review

MeSH terms

  • Bullying
  • Clinical Clerkship
  • Education, Medical, Undergraduate*
  • Humans
  • Organizational Policy
  • Professional Misconduct*
  • Racism
  • Schools, Medical*
  • Sexism
  • Shame
  • Social Environment*
  • Students, Medical / psychology*
  • United States