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Judith A. Richman, PhD; Joseph A. Flaherty, MD; Kathleen M. Rospenda, MA; Michelle L. Christensen

JAMA. 1992;267(5):692-694.

Abstract
Objective.
—To assess the prevalence, correlates, and mental health consequences of reported medical training—related abuses.

Design.
—A longitudinal cohort study of 137 students surveyed from medical school entrance (time 1) through the winter of the fourth training year (time 4).

Setting.
—A state college of medicine.

Outcome Measures.
—Reported training-related abuses (measured at time 4) and mental health status measured at times 1 and 4 (depressive and anxiety symptoms, hostility, problem drinking, escapist drinking, alcohol consumption levels, and gender role orientations).

Results.
—Seventy-two percent of students reported at least one abusive experience during medical training. Females were significantly more likely than males to report gender discrimination, exclusion from informal settings, discomfort from sexual humor, and unwanted sexual advances. Abuse was significantly related to most psychopathological outcomes, controlling for pre-existing psychopathology. Males low in masculinity and females low in femininity were most likely to report abuse.

Conclusions.
—The data provide further support for the assumption that a high proportion of medical students not only experience the training process as abusive in nature but also suffer measurable psychopathological consequences. Efforts should be made to reform medical education, with a prominent focus on gender role—related issues.

(JAMA. 1992;267:692-694)

Author Affiliations
From the Department of Psychiatry, University of Illinois at Chicago.

Footnotes
Reprint requests to Department of Psychiatry (M/C 913), University of Illinois at Chicago, 912 S Wood St, Chicago, IL 60612 (Dr Richman).

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