Medical student abuse during clinical clerkships in Japan.
OBJECTIVE
To assess the prevalence of medical student abuse during clinical clerkships in Japan.


METHODS
A cross-sectional questionnaire survey.


METHODS
Six medical schools in Japan.


METHODS
Final year (sixth-year) and fifth-year medical students in the period from September 2003 to January 2004. From a total of 559 students solicited, 304 (54.4%) returned the questionnaire, and 276 (49.4%: 178 male and 98 female) completed it.


METHODS
Prevalence of medical student abuse in 5 categories: verbal abuse, physical abuse, academic abuse, sexual harassment, and gender discrimination; differences in abusive experience between male and female students; types of alleged abusers; reporting abusive experiences to authorities; and emotional effects of abusive experiences.


RESULTS
Medical student abuse was reported by 68.5% of the respondents. Verbal abuse was the most frequently experienced abuse (male students 52.8%, female students 63.3%). Sexual harassment was experienced significantly more often (P<.001) by female students (54.1%) than by male students (14.6%). Faculty members were most often reported as abusers (45.2% of cases). Abuse occurred most frequently during surgical rotations (42.0% of cases), followed by internal medicine (25.1%) and anesthesia rotations (21.8%). Very few abused students reported their abusive experiences to authorities (8.5%). The most frequent emotional response to abuse was anger (27.1% of cases).


CONCLUSIONS
Although experience of abuse during clinical clerkships is common among medical students in Japan, the concept of "medical student abuse" is not yet familiar to Japanese. To improve the learning environment, medical educators need to take action to resolve this serious issue.
Nagata-Kobayashi
Shizuko
S
Department of General Medicine and Clinical Epidemiology, Kyoto University Graduate School of Medicine, Kyoto, Japan. sea@kuhp.kyoto-u.ac.jp
Sekimoto
Miho
M
Koyama
Hiroshi
H
Yamamoto
Wari
W
Goto
Eiji
E
Fukushima
Osamu
O
Ino
Teruo
T
Shimada
Tomoe
T
Shimbo
Takuro
T
Asai
Atsushi
A
Koizumi
Shunzo
S
Fukui
Tsuguya
T
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007564:Japan; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D012308:Risk Management / Q000706:statistics & numerical data; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014754:Violence