Medical students describe power imbalances and cut corners

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Medical students speak out against shortcuts and power imbalances in hospital rotations.

Photo: 123RF

A female student also told RNZ that she was pressured into submitting to a supervisor performing a physical examination – on her.

They came forward after an internal University of Auckland review found students were sometimes encouraged by supervisors to circumvent obtaining informed consent from patients.

One student said if there was anyone to blame it was the older staff members.

“They are an endangered breed,” he wrote. “Before, hospitals were controlled by anxious, anxious men who worshiped themselves and often prioritized their own egos over the well-being of patients.”

Another student described an incident where a supervisor acted inappropriately, but she was unable to speak.

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“One of my consultants had me practice exams with him in a closed room,” she said. “He ‘taught’ examination techniques on my body, which I knew were not part of the actual examination. It made me very uncomfortable, but because he was in such a high position, I felt like I couldn’t stop him.”

One account of the study describes a supervisor forcing a student to perform a rectal examination on an unconscious patient without his consent.

“I felt like the medical school didn’t care when I contacted them,” he wrote. “Even the top executives were either uncertain or indifferent. I was basically dismissed.”

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Medical Student Association president Thomas Swinburn said students knew the rules but found it difficult to speak up when they were broken.

“I would say 99.9% of the time students want to do the right thing,” he said. “But it’s not often easy to feel empowered and confident to speak up and say something.”

Other students share this sentiment. “It sounds bad, but there’s just no incentive to stand up to supervisors,” wrote a fifth-year student. “They won’t thank you for it, and to be honest, neither will the patient.”

The study’s lead author, Dr Harsh Bhoopatkar, said he was confident his study had put the University of Auckland on high alert.

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“It has to be a whole systems approach, and I think that’s the approach the faculty has taken,” he said. “It’s very encouraging to me as a researcher and teacher that the faculty have taken this seriously and have already done a lot.”

The assistant dean of medical sciences, Warwick Bagg, said the university needed to do better.

“We’re going to work to get it done better,” he said. “Informed consent is clearly defined and clearly taught. It must be done correctly.”

Bagg said the University of Auckland will work with hospitals to address student concerns.

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