Just fun or a prejudice? - physician stereotypes in common jokes and their attribution to medical specialties by undergraduate medical students.

BACKGROUND: Many jokes exist about stereotypical attributes of physicians in various specialties, which could lead to prejudices against physicians from a specific specialty. It is unknown whether and when medical students are aware of stereotypes about different specialties. The goal of this study was to analyze the degree of stereotypes that exist about medical specialties amongst undergraduate medical students at different stages of their education. METHODS: One hundred fifty-two jokes with different content about attributes of physicians from different specialties were found by an internet search. In total, 36 characteristics of the five specialties of anesthesia, general surgery, internal medicine, orthopedics, and psychiatry were extracted from the jokes and they constituted the basis for the development of an online questionnaire. The questionnaire allowed each characteristic to be assigned to one of the five specialties and was sent to 999 undergraduate medical students from semester 1, 7, and 12 at the Medical Faculty of Hamburg University. RESULTS: Three hundred eight (30.8%) of the invited students completed the survey. The characteristics of general surgeons and psychiatrists were assigned congruently most frequently (>50%). For internists and orthopedics, there was a significantly more congruent assignment of the characteristics by final year students versus students in their first semester. Male students assigned the characteristics of anesthetists and internists significantly more congruently than female students. The three characteristics "…are a bit slow on the uptake", "…consider income to be relatively unimportant", and "...apologize a lot" were not assigned to any of the five specialties by more than 50% of the students. CONCLUSIONS: While stereotypes about physicians from certain specialties seem to exist commonly, medical educators need to be aware that stereotypes about specialties might develop during undergraduate medical training. In order to support students in their professional identity formation without developing stereotypes, medical educators should receive training. Performing a similar study with physicians in postgraduate training would shed some light on stereotypes and prejudices that might develop at a later stage in medical education.

Rosuvastatin-induced rhabdomyolysis: case report and call for proactive multifactorial risk assessment and preventive management of statin therapy in high-risk patients.

Cholesterol-lowering statins are frequently prescribed for primary and secondary prevention of ischaemic vascular events. Whereas most patients tolerate statins without problems, statin-associated myopathy is well documented, as are several risk factors. We present a case report of an 80-90-year-old man with coronary artery disease who rapidly developed severe rhabdomyolysis during treatment with rosuvastatin while in intensive care. He had several concomitant risk factors for statin-induced myopathy including high dosage, old age, renal and hepatic impairment, and a pharmacogenetic SLCO1B1*1 a/*5 variant. Single known risk factors have a low predictive value for statin-induced myopathy and may therefore be underestimated in clinical practice. However, adverse drug reactions frequently involve the joint action of a multitude of environmental and genetic component causes, and statin-induced myopathy should be regarded as a multicausal event. We therefore advocate a proactive multifactorial risk assessment to guide and individualise statin therapy in high-risk patients.