We know three things about mistreatment of medical students and trainees: (1) it is unethical, (2) medical schools and hospital systems are mandated to address it effectively, and (3) medical student reports of mistreatment have not diminished since the problem was first documented more than 20 years ago. Contributors to the March 2014 issue sort out why reported incidents of mistreatment have not declined despite efforts to curb the practice. Major hurdles to reform include medical education’s traditional rites of passage, difficulty in defining mistreatment precisely and collecting valid data about its occurrence, and inability to discipline offenders on the basis of anonymous reports.
Medical school faculty have a nonnegotiable duty to report students whose professional behavior falls seriously short of the mark. If they refrain from fulfilling this duty for fear of retaliation, the antiharassment pendulum has truly swung too far.
The eradication of hazing has not diminished the socialization, camaraderie, or commitment of new recruits. The physical, emotional, and mental demands of basic training suffice to produce the outcomes previously ascribed to hazing.