Survey points to bullying during psychiatrists’ training

BULLYING and harassment are common experiences during psychiatry registrar training in South Africa and are under-reported.

In correspondence in this month’s SA Medical Journal, experts who served as members of the Council of Psychiatrists, Colleges of Medicine of South Africa, for the triennium 2017-2020, aimed to understand how workplace experiences and supervision could affect training and examination outcomes, with a focus on bullying during specialist psychiatric training.

Authors Natalie Beath of Stellenbosch University; Ugasvaree Subramaney at Wits; Zukiswa Zingela at Walter Sisulu University; Bonginkosi Chiliza at University of KwaZulu-Natal; John Joska at UCT; Carla Kotzé at the University of Pretoria; and Soraya Seedat at Stellenbosch University conducted a cross-sectional, descriptive study of registrar trainees in psychiatry at eight universities between June 1 and November 30, 2019.

They conducted an online survey that included questions on bullying and discrimination.

The estimated number of psychiatry registrars in the country was 179, and in this study the authors received 70 responses.

Thirty-four of the registrars reported having been bullied or harassed.

Consultants (21) were most frequently cited as the culprits, followed by patients or patients’ relatives (17), hospital management (12), other registrars (11), nurses (9) and lastly university management (2).

“The most frequently experienced type of bullying was belittling/humiliation (26), followed by being threatened/insulted (17), being deliberately prevented from accessing training (7) and other forms of bullying (2). These were ‘silent treatment’ by nurses and being forced to work in an unsafe clinic,” the authors said.

Of the respondents who reported experiencing harassment/bullying, 35.3% reported being afraid of the consequences should they report the incident; 23.5% indicated they had reported the issue and that it had been resolved; 17.6% stated they had reported it but that it had not yet been resolved or that they still intended to report it; 14.7% felt that reporting the incident would not make a difference; and 8.8% thought that the incident was not serious enough to report.

“These findings are of considerable concern in view of the negative consequences that bullying has been shown to have on registrars’ mental health and consequently on rates of burnout, substance abuse, satisfaction with residency and entertaining thoughts of programme non-completion.

“Bullying has also been found to negatively affect professionalism, teamwork and communication, with downstream impacts on patient morbidity and mortality,” the authors said.