Behind the Scrubs: Bullying’s Grip on Sri Lanka’s Intern Doctors

Hey, Let’s Talk About Something Tough

You know, we often picture doctors as these calm, collected heroes, right? Especially the junior ones, the interns, fresh out of medical school, ready to save the world. But what if I told you that for many of them, the hospital floor isn’t just challenging because of long hours and tough cases? What if it’s also a place where they face something far more insidious: bullying?

I stumbled upon this study about intern doctors in Sri Lanka, and honestly, the findings are pretty eye-opening. It dives into the prevalence of workplace bullying among these folks who are just starting their careers, and it’s a topic that really needs our attention. We’re talking about the very people we trust with our health, and they’re going through some serious stuff behind the scenes.

What Exactly Are We Talking About?

First off, let’s get clear on what workplace bullying means in this context. The study uses a definition that calls it ‘situations where an employee is persistently exposed to negative and aggressive behaviours at work, primarily of a psychological nature with the effect of humiliating, intimidating, frightening or punishing’. Basically, it’s not just a bad day or a tough supervisor; it’s ongoing, harmful behaviour. It can range from really obvious physical stuff to subtle words or actions that just chip away at someone’s confidence and progress.

The medical world, with its old-school hierarchy and power dynamics, seems particularly vulnerable. Sometimes, it’s even weirdly seen as a “functional educational tool,” which, let’s be real, sounds like a fancy way of justifying unacceptable behaviour. And for a profession built on compassion and care, that’s a bit of a disconnect, isn’t it?

The Shocking Numbers

Alright, brace yourselves. This study, which looked at intern doctors in Sri Lanka who had completed at least six months of their internship, found that a staggering 76.9% of them had experienced workplace bullying. Yeah, you read that right. Over three-quarters! That’s way higher than what some studies in Western countries report, though it seems to be sadly similar to findings in other South Asian nations like Pakistan.

They looked at different forms of bullying, and guess what? All of them were common:

• Work-related bullying: This included things like having their opinions ignored (56.7%), being told to do work below their skill level (55.3%), and being swamped with unmanageable workloads (50%).
• Person-related bullying: Think being ridiculed about their work (55.8%) or getting constant criticism for mistakes (52.4%). Almost half (48.1%) even got hints that they should just quit!
• Physical intimidation: This one is particularly alarming. A majority (61.1%) faced intimidating behaviours like finger-pointing, invasion of personal space, shoving, or having their way blocked. And get this – 18.3% reported threats of physical abuse or even actual abuse. Yikes.

That last point, the physical stuff, is significantly higher than reported in many other places. It makes you wonder about the work environment – is it so hostile that people feel they can get away with physical intimidation?

Why Here, Why Now?

The study suggests that this isn’t new in Sri Lanka. A study from way back in 2004 showed similar issues with unacceptable behaviour towards medical students and interns. It seems like it’s a deep-seated problem, possibly linked to a really strict medical hierarchy and a culture that traditionally values seniority above all else. In this system, bullying can almost become like a twisted ‘rite of passage’ for junior staff.

There are also cultural factors at play, according to the study. Sri Lankan culture might emphasize resilience and keeping quiet about your struggles. Internship is sometimes seen as a period where junior doctors just have to tough it out, silently bearing all the stress. This combination of a punitive hierarchy and a culture of silent endurance might actually make it harder for people to report bullying, allowing it to continue.

Plus, the study points out that bullying behaviour can start young in Sri Lanka and carry on into adulthood and workplaces, including universities (think ‘ragging’ or hazing). It’s like the hierarchical structure of medicine just provides fertile ground for these behaviours to keep going, especially when victims at the bottom feel they can’t speak up.

What’s Associated with This?

The study found a couple of factors linked to experiencing bullying. Interns from the majority Sinhala ethnicity were more likely to report being bullied compared to minority ethnicities. The authors suggest this might be because there weren’t many people from minority groups in the study, or maybe minority populations are less likely to report it.

Another big factor was feeling that the assigned work was frequently above their capacity. This makes sense, right? If you’re already feeling overwhelmed, you might be more vulnerable, or perhaps being bullied makes you *feel* more overwhelmed. It’s a bit of a chicken-and-egg situation, but the link is clear.

Interestingly, the study didn’t find a significant link between bullying and things like sex, the specific medical specialty they were interning in, or difficulty communicating in English.

The Real Cost

This isn’t just about hurt feelings. Bullying has serious consequences. For the doctors themselves, it can lead to:

• Job dissatisfaction
• Burnout
• Feeling like they’ve lost their clinical skills
• Depression

And get this: it doesn’t just affect the doctors. It can indirectly harm patients too! When doctors are stressed, burnt out, or feeling demoralized, it can lead to medical errors, which in turn can endanger patient safety and, in the worst cases, even result in death. It seems pretty obvious that if we want good patient care, we need to take care of the people providing that care.

Looking Ahead

The study authors are pretty clear: this is a rampant problem that needs serious attention from policymakers. They suggest creating professional workspaces where bullying simply has no place. What could help?

• Teaching skills like assertiveness to medical students and junior doctors.
• Setting up solid reporting mechanisms so people can speak up safely.
• Making sure psychological support is available for doctors who experience bullying.

This study is important because it highlights a major issue affecting the mental health of junior doctors in Sri Lanka, using a well-known tool to measure bullying. It sheds light on a problem that’s been hiding in plain sight, perhaps enabled by culture and hierarchy.

Of course, like any study, it has limitations – it relied on voluntary responses, which might skew the results, and it didn’t look into who the bullies were or what actions victims took. But even with those points, the main finding is loud and clear: bullying is a huge problem for intern doctors in Sri Lanka, including alarming levels of physical intimidation.

It seems like Sri Lankan medicine needs some major systemic changes and much better support systems for its junior doctors. It’s time to move towards creating supportive work environments, not ones where bullying is just part of the journey.

Source: Springer