Forensic aspects of medical student abuse: a Canadian perspective.

The mistreatment and consequences of mistreatment involving medical students have only recently been recognized and studied. This article reports on the nature, frequency, and sequelae of "abuse" that is prohibited by the Criminal Code of Canada, as experienced by fourth year medical students. A 160-item, multiple choice questionnaire, the Medical Student Abuse Survey (MSAS), was administered on a voluntary and anonymous basis in February 1992 and 1993 at the University of Toronto (Canada) Faculty of Medicine. All students enrolled in their fourth year (n = 500) were eligible. Of those present when the survey was administered (n = 415), 72.5 percent (301 of 415) responded. Of all respondents, 8.3 percent (25 of 301) experienced either threats of bodily harm, assault, or assault with a weapon; 12.6 percent (38 of 301) experienced physical sexual advances; four students experienced both. Perpetrators were most often clinicians in a surgical setting. Only about one-third of these students (21 of 59) complained to someone in a position of authority within the medical school, and no one reported these incidents to the police. There is a need within medical training programs to disseminate a "code of conduct" to all parties, familiarize students with complaint procedures, and improve the identification and rehabilitation of perpetrators. The lack of objective measures for verifying students' experiences of abuse remains a limitation of this study.

Differences in abuse reported by female and male Canadian medical students.

OBJECTIVE: To assess differences between male and female medical students concerning their experiences of abuse during training in a large Canadian medical school. DESIGN: Voluntary, anonymous cross-sectional survey of first- and fourth-year medical students during February 1991. SETTING: University of Toronto School of Medicine. PARTICIPANTS: Of 396 first- and fourth-year students surveyed after one of their regular classes, 347 (117 women, 230 men) completed the questionnaire. INTERVENTION: A 165-item, multiple-choice questionnaire concerning experiences of verbal or emotional abuse, sexual harassment and physical abuse, completed within 30 minutes. MAIN OUTCOME MEASURES: Differences between male and female respondents in abuse experiences before and during medical training, the relation between abuse before and during training, and the psychologic and behavioural effects of abuse during training. RESULTS: The experiences of the male and female respondents differed mainly in regard to sexual harassment: 42% (49/117) of the women and 11% (25/230) of the men reported sexual harassment before entering medical school (p < 0.0001); 46% (54/117) and 19% (43/230) respectively reported sexual harassment during medical training (p < 0.0001); and women who reported sexual harassment were the only respondents for whom a significant relation was found between abuse before and during training (p < 0.043). The women were more distressed than the men by all forms of abuse. A significant relation was shown between male students who reported experiencing abuse during medical training and mistreating patients (p < 0.0001). CONCLUSION: Female students' experiences of sexual harassment differed from those of their male counterparts. As well, the female students' reactions to and ways of coping with all types of abuse differed from those of the male students.

A study of the drop-outs in psychopharmacological research with bulimics.

Given the high drop-out rates frequently noted in drug trials with bulimic subjects, we have attempted to correlate drop-out status with a greater level of psychopathology as measured by a thorough standardized psychological assessment battery (NIMH-DIS, EDI, POMS and SCL-90). Despite a trend toward higher scores on the Paranoid Ideation Subscale of the SCL-90 among drop-outs compared to completers, there were no significant differences found between the two groups participating in a fifteen week double blind crossover study on the effectiveness of desipramine in bulimia.