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Medscape
3 days ago
- Health
- Medscape
Harassed in Med School
Medical school is a fast-paced, high-pressure environment where students are expected to excel. As part of their training, they learn to navigate tense interactions with faculty, residents, peers, and patients. But what happens when those interactions cross a line and students feel harassed, mistreated, or humiliated? Nearly 40% of medical students reported experiencing harassment during med school, according to the Association of American Medical Colleges' (AAMC's) most recent survey of 2023-2024 graduates. The behaviors include being publicly humiliated or subjected to sexist, racist, or ethnically offensive remarks or names. In addition, almost 40% of graduates reported being publicly embarrassed. Clinical rotation faculty were cited as perpetrators of most of the negative behaviors in the survey. As the AAMC questionnaire shows, mistreatment continues to take place in medical schools despite policies that seek to curb it. Caroline Beit was 4 months pregnant when she entered the Johns Hopkins School of Medicine, Baltimore, in the fall of 2024. From her first day until she gave birth to her daughter earlier this year, she claims she was verbally harassed by faculty and students about her choice to have a baby while attending medical school. She said that one professor told her class that pregnancy was a 'truly horrible disease.' Another initially referred to pregnancy as a 'disease state' before telling the class that their classmate could tell them all about pregnancy. 'The attention on my pregnancy from the entire class embarrassed me,' Beit told Medscape Medical News . In addition, Beit said she felt harassed by students, who asked if they could watch the birth. They commented on her changing body, inquired whether it was a planned pregnancy, and even suggested she have an abortion. She also said that fellow students told her that she should take an exam elsewhere in case she went into labor and distracted them. In response to Medscape Medical News' inquiries about the complaint, a Johns Hopkins University spokesperson said that the school protects student privacy under federal law and could not comment on individual cases or complaints. 'We have long-established policies in place that strictly prohibit discrimination and harassment,' read an emailed statement from a university spokesperson . 'We take all reports seriously and evaluate each one to take appropriate action. If any member of our community experiences or witnesses such behavior, we encourage them to contact the Office of Institutional Equity [OIE],' the statement read. 'The School of Medicine has additional resources to respond to student concerns and address a wide range of potential issues, and we are continually working to ensure that all of our students are treated with fairness and respect.' About Medscape Data Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, a soon-to-be-published report on medical school stressors found that One quarter of fourth-year med students have been harassed or bullied by attendings or residents. 19% of med students reported bullying by fellow students. In addition, nearly 30% of students reported unwanted advances from patients, followed by such advances from peers. Among female students, the rate of unwanted advances from patients, 38%, was slightly higher, according to another Medscape report. Filing a Complaint Nathalie Feldman, MD, director of the Learning Environment at The Robert Larner, MD, College of Medicine at the University of Vermont (UVM), Burlington, Vermont, encourages students who believe they've been mistreated to file a report. She said that the bar is very low for reporting at their institution, so they will address anything that makes students feel uncomfortable. She also added that students have a QR barcode on the back of their name badges connecting them with forms to report concerns or unprofessional behavior. 'We try to decrease as many barriers to reporting as possible,' said Feldman, an associate professor in the medical school's Department of Obstetrics, Gynecology, and Reproductive Sciences. Beit said that she filed informal complaints with Johns Hopkins' Office of Medical Student Affairs and formal complaints with the Mistreatment Incident and Learning Environment Surveillance (MILES) Committee, which promotes a safe and respectful learning environment for medical students. MILES must notify and file a complaint with the OIE, which oversees compliance with antidiscrimination and harassment policies. Beit added that MILES also changed her to a different professor's group. In response to the complaints, one professor sent a written apology to her group that he had erred and that 'it was wrong to classify pregnancy as a disease.' She doesn't believe the other complaint was resolved, nor that her complaints led to any significant institutional changes. She didn't file complaints against her fellow students. Why Misbehavior Occurs in Med School Beit is not alone in her claims of mistreatment in medical school. Among the findings of the AAMC's 2024 graduation questionnaire, about 20% of students reported being publicly humiliated, 13% subjected to offensive sexual remarks or names, and nearly 9% experiencing racially or ethnically offensive comments. The statistics have improved slightly since 2020, with more students knowing how to report mistreatment at their schools and reporting it, according to the survey. While most medical educators and staff are 'professional and well-meaning,' some abuse their power, said Tim Lacy, senior director of Student Learning Environment at the University of Illinois College of Medicine, Chicago. 'Some people with poor intentions are opportunistic, taking advantage of sincere or naïve medical students.' Feldman believes that some contributing factors to mistreatment, harassment, or public humiliation of medical students might relate to the hierarchal system of teaching hospitals and to generational differences in communication styles between students and faculty or other supervising clinicians that can cause tension, especially in the 'high-stakes, high-acuity' environment of patient care. Feldman added that often the harassing or bullying behavior isn't intentional but rather committed by individuals who were taught with those same public humiliation techniques and may be unfamiliar with how language and training have evolved. Halting Harassment The Liaison Committee on Medical Education (LCME), an accrediting body for educational programs at schools of medicine, requires medical schools to set standards for student mistreatment, among other qualifications for accreditation. Medical schools are expected to develop written policies that define mistreatment, have mechanisms in place for prompt responses to complaints, and support educational activities that prevent mistreatment, according to the current LCME standards. The LCME standards include general guidelines for creating respectful learning environments and relationships, but ultimately, schools have flexibility in how they apply the principles, so policies differ by school, said Geoffrey Young, AAMC senior director for the Transforming the Health Care Workforce unit. For instance, the University of Illinois College of Medicine has a code of professional conduct for teacher-student relationships and standards for reporting student mistreatment in its Positive Learning Environment Policy. Per the policy, 'Publicly humiliating, physically harming, exploiting, and/or subjecting an individual to unwanted sexual advances are all examples of mistreatment.' Schools must also ensure students understand how to report mistreatment and that 'any violations can be registered and investigated without fear of retaliation.' Among the reasons graduates do not report such incidents are a belief that the school will not act and fear of reprisal. 'Even though there's a policy and a reporting process, we still know there's underreporting because of fear of retribution and retaliation. It's my job to make sure students feel confident and reassure them by reporting and representing their best interests,' Lacy said. He advises students that filing a complaint might affect their career options. If they want to proceed, he cautions students to file reports well before grades are released so the complaint doesn't appear to result from grading. Some students may even delay complaints until after they graduate to avoid repercussions, Lacy said. Beit admitted that she was afraid of repercussions and still is. 'I worry that, given that I have 3 years left, that I will continue to be harassed for having a child while in medical school.' When a student comes to Lacy with concerns, he clarifies whether they want to consult with him confidentially or report an issue. He told Medscape Medical News that most students want a sounding board. The conversation may occur in person, through video conferencing, or via email. Lacy said he tries to respond to the initial report within a day or two, but a complete institutional response to the situation can vary from a day to several weeks. Most of the reports of abuse are from third-year medical students, he added. 'As the year progresses, they come to realize a range of normal clinical behaviors and begin to be comfortable reporting events outside of that range.' In some cases, the school can resolve the situation without reporting an incident. Lacy cited a recent student complaint he received through email, prompting him to speak with the education dean and clerkship director to resolve the issue. 'I consult with whoever has the power to change the situation.' Feldman explained that the tiered resolution process at The Robert Larner, MD, College of Medicine at the UVM starts with an informal dialogue and, if necessary, escalates to a formal investigation. Faculty members may be removed from teaching activities until they complete coaching or a remediation program. If that doesn't prevent recurrence, the incident might be documented in their professional record, leading to other more severe disciplinary actions, such as decreased responsibilities or losing their job. However, Feldman said, 'That's extremely rare, but it's possible.' At the University of Colorado School of Medicine, Aurora, Colorado, several policies and processes help protect students from unprofessional behavior, including a Teacher-Learner Agreement and a Mistreatment Policy. The latter refers students who witness such behavior to the Office of Faculty Relations, which can provide support and help them report incidents. The office directs students whose concerns involve discrimination, sexual misconduct, or harassment to the CU Office of Equity. 'We will talk the student through the process and let them know what to expect,' said Abigail Lara, MD, assistant dean for faculty relations. Resolution procedures run the gamut from potential sanctions against staff who violate the policy — a warning, a written letter of reprimand, or the employee's firing. Other sanctions may include mandatory training, demotion, change in job responsibilities, reduced salary, ineligibility for merit increases, or denying access to all or a portion of the university's property. Protecting Students Two years ago, the University of Colorado School of Medicine launched an antimistreatment effort that analyzed their students' reports of negative behaviors on the AAMC graduation questionnaire surveys from 2019 to 2023. The school conducted its own survey at the end of the clinical rotation period and held focus groups with students, Lara added. She said the campaign decreased experiences of bullying and mistreatment. In addition, if a student reports mistreatment on the survey, it automatically flags an administrator to reach out to the student to see if they want to discuss the issue further. UVM's medical school saw a 'dramatic decrease' in student mistreatment reports from the operating room (OR) when students were better trained to maintain a sterile field, a concern of OR nurses, Feldman said. 'New students were coming into the operating room, and the nurses would bark at them if they got too close to the table. Students reported it as mistreatment to us. So, we created a shadowing [opportunity] where students could follow a patient care associate to learn how to keep a sterile field,' she said. 'Then we went back to the perioperative staff, the nurses where the mistreatment was coming from, and they said the students were so much better prepared. We involved them in training our students, and they were empowered to then teach them the right way to keep a sterile field.' Feldman added that involving the students in the resolution process also can help ease tension. They can also refer students to counseling and psychiatry services to help them cope with the aftermath of an incident. Despite policies and methods for resolving conflicts, Beit believes med schools like hers that value diversity of experiences in their incoming classes should better protect those who don't fit the mold of the traditional student. 'Policies technically prevent discrimination and harassment. In practice, they are not doing enough to protect students,' she said. She understands the risks she took bringing attention to a perceived injustice. But she didn't think the school culture would change unless she spoke up. If medical students feel they've been bullied or harassed, Lacy recommends: Keep a recurring journal or send an email to yourself with the details of an incident. Take notes while you can remember the conversations and specifics, especially if you're considering action in the future. Document the incident with evidence, such as screenshots of chats, in case they are deleted later. If you're unsure about reporting an incident, find a trusted staff member, faculty member, or student leader to consult. Report incidents sooner rather than later so concerns are taken seriously and can be investigated timely.
NBC News
08-07-2025
- Business
- NBC News
Medical students fret over the new student loan cap in the 'big, beautiful bill'
A provision tucked inside a sweeping bill signed into law by President Donald Trump last week will make it harder for thousands of aspiring doctors to finance their education as the country faces a growing shortage in that profession. The move will cap the amount of federal loans students can borrow for graduate school to $20,500 a year — with a total limit of $100,000 — and cap loans for professional programs, such as medical, dental or law school, at $50,000 a year, with a total limit of $200,000. While those limits may sound like large amounts, medical school students graduate with an average of more than $264,000 in educational debt and the cost of medical school programs can exceed $300,000 at private universities, according to the Education Data Initiative. Without the ability to take out more federal loans, prospective students say they will have to turn to private loans, which can have stricter borrowing or repayment options, or potentially put off their medical school plans. 'I have watched a lot of students get into debt, and it is scary, but part of the medical training and the medical education system, it's an expensive journey. I think that it's something that the government needs to understand,' said Zoe Lewczak, a 26-year-old bioethics master's student at Harvard Medical School, who is in the process of applying to 30 schools for MD-Ph.D. programs. ' What is currently happening, I think this is going to create a major gap in who is able to access medical education and pursue it.' The legislation, which Republicans have dubbed the 'one big, beautiful bill,' largely focuses on providing trillions of dollars in tax cuts for businesses, increased spending for immigration enforcement and cuts to health insurance programs. But within the nearly 900-page law are several changes to student loan programs, including the elimination of a loan program put in place in 2006 called Grad PLUS, which allows students to borrow up to the full cost of attendance. The Grad PLUS loans were initially intended to help more people attend graduate and professional programs. But opponents of the loan program have argued that it has allowed colleges and universities to increase tuition unchecked because students have been able to borrow essentially unlimited amounts of money, leaving borrowers with financially crippling levels of debt. Medical schools have warned the loan cap could discourage students from going into medicine at a time when the country is already on track to have a shortage of as many as 86,000 physicians by 2036, according to the Association of American Medical Colleges. The group said that medical school tuition increases have slowed since the introduction of the loan program. 'This will intensify challenges for medical students to finance their education due to some of the complexities of private loans, and we believe it will result in an additional financial barrier to attending medical school,' said Kristen Earle, AAMC program leader for student financial aid services. 'This added barrier could deter qualified candidates from pursuing a medical degree altogether, ultimately worsening the existing and expected physician shortage.' The student loan cap comes as universities are already struggling with wider funding cuts. Trump has sought to cut off various forms of federal funding for institutions that have policies with which he disagrees, and the Department of Government Efficiency has cut or frozen medical and scientific funding schools rely on. For Lewczak, the loan cap will likely force her to find financial assistance beyond the government. At her top-choice medical school, the average student leaves with $400,000 in debt — double the loan limit that will be imposed by the bill. With the new loan cap, she's considering taking out private loans, something she thinks should be an option since she has built up good credit. 'There seems to be this misconception that federal student loans are just like free handouts, and that is very much false,' she said. 'You are signing an agreement, you are paying it back with the interest rate.' While private loans will still be an option for some students, those loans aren't eligible for public service loan forgiveness programs, like those for doctors who work in underserved communities. Private loans can also come with less flexible repayment options or require the borrower to have a co-signer, Earle said. As a first-generation college student, Lewczak created a TikTok account to help students figure out how to fund graduate school in higher education. She predicts the new law will create a gap in students who want to pursue medicine and students who can actually access that education. Other current and prospective medical school students have also taken to social media to share their concerns over the loan limit. Shae-Marie Stafford-Trujillo, 23, who is completing a one-year post-bachelor certificate program at Baylor School of Medicine in Houston, said the bill is already dashing her hopes of studying at some of her top-choice medical schools, like Stanford University, where one year of attendance costs more than $150,000. 'You can imagine how almost surreal it feels to not even be able to go to an institution and study that,' said Stafford-Trujillo, who hopes to specialize in research around narcolepsy, a condition she has personally struggled with. 'It's not even across the world, it's potentially only a couple of 100 miles away, but now I don't even have the opportunity to go and study at some of these institutions.' Unless she gets into an MD-Ph.D. program, which could be fully paid for, Stafford-Trujillo likely will only be able to afford an in-state medical school in Texas. 'You could imagine and empathize with now students are no longer able to apply broadly or to apply to programs, potentially their dream school,' she said. Lauren Garkow, 25, is halfway through a four-year medical school based in the Caribbean and is interested in pursuing a career in pathology when she graduates. She said her classmates have already struggled to afford even the basic necessities — a struggle she expects to get even worse if loans are limited. 'I really fear for all the medical students who have to deal with that new bill,' she said. 'Health care as a whole will be affected,' she said. 'This is going to have a ripple effect on all of us.'
Business Insider
08-07-2025
- Business
- Business Insider
A big change to student loans in Trump's spending bill could make it harder to become a doctor or lawyer
It might soon be harder to attend medical or law schooldue to President Donald Trump's big spending bill. Trump signed his "big beautiful" tax and spending bill into law on July 4, codifying a slew of changes to the tax system, healthcare, and education. The law includes a major overhaul to the country's education system, particularly to the way students take out and pay off their student loans. One specific student-loan change in the bill places new caps on the amount of loans students can borrow for graduate school, including medical and law school. Specifically, the bill eliminates the Grad PLUS loan program, which allowed graduate and professional students to borrow up to the full cost of attendance for their programs. It also caps borrowing for graduate students at $20,500 a year and $100,000 over a lifetime and for professional students, like those in medical or law school, at $50,000 a year and $200,000 over a lifetime. Those caps mean many students won't be able to borrow enough to cover the full price of graduate or professional school. The Association of American Medical Colleges found that the median cost for four years of public medical school was $286,454 for the class of 2024, with that amount rising to just over $390,000 at a private school. The average total cost of law school in the latest school year, according to the Education Data Initiative, was just over $217,000. "Eliminating or restricting these critical programs would undermine the future physician workforce and ultimately make it harder for patients in communities nationwide to get the care they need," AAMC's president and CEO, David Skorton, said in a statement. Sara Partridge, associate director for higher education policy at the left-leaning think tank Center for American Progress, told Business Insider that she expects these new caps to worsen doctor shortages and "shut off pathways to these important jobs for students from low income families." The Health Resources and Services Administration — a federal agency that ensures healthcare access — said in a 2024 report that 75 million people currently live in a primary care health shortage area, and it projects a shortage of 187,130 full-time physicians in 2037. Some students might also turn toward private student loans with higher interest rates, Partridge said. "Private student loans often require a cosigner, so some students may not qualify, and they may have no options to fully finance and attend graduate school. So there is a possibility that for some students, this will be a barrier to accessing graduate school," Partridge said. The parent PLUS program, which previously allowed parents to borrower up to the full cost of attendance, still exists, but the bill places a $65,000 lifetime cap on parents borrowing for their kids' educations. Along with the borrowing caps, the spending bill also instituted significant changes to student-loan repayment. It eliminated existing income-driven repayment plans and replaced them with two new options. The first option is a standard repayment plan with a payment period ranging from 10 to 25 years, based on the borrower's original balance. The second option is a new plan called the Repayment Assistance Plan, which sets borrowers' payments at 1% to 10% of their income, and any remaining balance is forgiven after 30 years. It's less generous than former President Joe Biden's SAVE plan, which the bill eliminated. The SAVE plan would have reduced payments on undergraduate loans from 10% to 5% of a borrower's discretionary income. Linda McMahon, Trump's education secretary, lauded the passage of the bill in a July 3 post on X, saying it "simplifies the overly complex student loan repayment system" and "reduces federal student loan borrowing amounts to help curb rising tuition costs." "A truly beautiful bill for the American people," she said. The Department of Education did not immediately respond to a request for comment from BI.
Forbes
03-07-2025
- Health
- Forbes
Can Primary Care Survive Burnout, Bureaucracy, And A Broken System?
The fading art of the family doctor—will tradition survive the future of healthcare? Remember the primary care physician of yore? The doctor out of a Norman Rockwell illustration who knew you, your parents, your children, who was your trusted confidant, who you turned to for every sore throat and annual physical. Today, that relationship feels like a quaint relic, replaced by rushed visits, rotating clinicians, and an endless amount of paperwork. Today, this backbone of healthcare is facing a hard reboot. Burnout, bureaucratic bloat, and disruptive market forces are testing its resilience. But is this the end of the family doctor — or the birth of a reimagined model? The Perfect Storm: A Specialty Under Siege The numbers paint a dire picture. The shortage of physicians is being driven by an aging population and by aging physicians themselves — over a third of PCPs are over 55 — while fewer than 30% of residents plan to enter traditional primary care, with most opting for better-paying specialty roles. A new AAMC study projects a shortfall of 37,800 to 124,000 physicians by 2034, with primary care physicians (PCPs) bearing the brunt. Compounding the crisis: only 85 PCPs exist per 100,000 Americans, a ratio woefully inadequate for an aging, chronically ill population. What's more, if you are one of the 50 million Americans who reside in rural areas, only 9% of the nation's physicians practice in these communities. The culprit? There are a few. A system that puts paperwork over patients. PCPs spend two hours on paperwork for each hour of direct patient time. This includes time treadmilling on administrative tasks and EHR (Electronic Health Records) event logs and prior authorizations. Add stagnant reimbursements and median student debt exceeding $200,000, and the primary care exodus becomes both understandable and inevitable. The Reinvention Game Plan Fortunately, necessity is the mother of invention. Across the country, new thinking is rewriting the rules: Technology at the Bedside New tools promise to offload burdens and personalize care. Under recent Medicare rule changes, physicians can bill for remote patient monitoring and virtual check-ins, opening revenue streams and supporting proactive outreach. Why Retail Clinics Can't Fill the Gap Big players like CVS and Walmart promised disruption and primary care for everyone with much-touted retail clinics, but many have closed amid disappointing patient engagement. Consumers consider retail health as transactional — a quick fix for a sore throat, perhaps not as long of a wait as urgent care, but not for managing chronic disease or complex care plans. Without the deep, long-term relationships that PCPs cultivate, outcomes suffer, and trust Can Patients Do About All This? While the system evolves, patients also play a crucial role in preserving and improving primary care. The stakes are high: studies show that patients with a consistent primary care relationship have better health outcomes, lower costs, and fewer hospitalizations. 'As a family physician, I've seen firsthand how having a trusted primary care doctor can truly change the course of someone's life,' says Sarah C. Nosal, MD, FAAFP, President-Elect of the American Academy of Family Physicians (AAFP). 'When patients have a usual source of care—someone who knows their health history, understands their goals, and can guide their health journey—they're more likely to stay on top of preventive care, manage chronic conditions, and avoid unnecessary hospital visits. Family medicine is about connection, continuity, and ultimately, better health and longer lives.' Here's how you can advocate for your health and your doctor: 6. Understand Your Insurance • Learn what preventive services (e.g., vaccines, screenings) are fully covered under your plan to avoid surprise bills. The future of family doctors hinges on both systemic reform and everyday choices. While clinicians and policymakers wrestle with large-scale solutions, patients wield surprising power—by demanding continuity, leveraging technology thoughtfully, and investing in relationships with their PCPs. These small acts compound into transformative change: preserving the human core of primary care while embracing innovation. The result? Better health outcomes today, and a blueprint for a system where the future of family doctors isn't just secure, but sustainable.
Time of India
16-06-2025
- Entertainment
- Time of India
Tisca Chopra shares she had a blast shooting 'Ankur Arora Murder Case' as the film turns 12
It has been more than a decade since actress Tisca Chopra was seen as a doting mother Nandita Arora who wanted nothing more than for her son to get better in the movie "Ankur Arora Murder Case". It has been more than a decade since actress Tisca Chopra was seen as a doting mother Nandita Arora who wanted nothing more than for her son to get better in the movie "Ankur Arora Murder Case". Commemorating 12 years of the film's release, Tisca took to her official Instagram handle and penned a note recalling her time on the set. She wrote, "It's been 12 years to Ankur Arora Murder Case. . What a blast we had at shoot @kaykaymenon02 @arjun__mathur @paoli_dam @vishakhasingh555 @chaudhari_manish #harshchhaya @sachiink and of course our director @suhailtatari enjoying the fab food from @kaykaymenon02 film was brilliantly cast by @kunalmshahcasting." Tisca further revealed that as she was working on the movie, around the same time she was also blessed with her baby girl Tara, making the film extremely special to her. "AAMC will always remain very close to my heart. We got Tara around the same time, and that made the role even more personal - the fear, the helplessness, the love... it all felt very real.. I still remember at a screening of the film, @azmishabana18 just held my hand. She didn't say a word. And in that silent moment, I knew that we had a very real film..," she added. Made under the direction of Suhail Tatari, "Ankur Arora Murder Case" shares the real-life story of a little boy who dies on the operation table due to medical negligence. It talks about a highly reputed doctor whose small mistake ends up costing the life of a little kid. Will the doctor be able to hide his mistake or will the grieving mother get justice? Accompanying Tisca, the core cast of the drama further includes Arjun Mathur , Kay Kay Menon , Paoli Dam , Harsh Chhaya, Vishakha Singh, Sachin Khurana, Manish Choudhary, Kanchan Awasthi, Vishesh Tiwari, and Khushboo Kamal, along with others. Produced and written by Vikram Bhatt , "Ankur Arora Murder Case" reached the theatres on 14 June 2013.
