Medical students describe power imbalances and cut corners

Medical students are speaking up about inappropriate behaviour from supervisors.

By Felix Walton of RNZ

Medical students are speaking out about cut corners and power imbalances in hospital placements.

One student also told RNZ she was pressured to submit to a supervisor carrying out a physical exam - on her.

They came forward after an internal review by the University of Auckland revealed that students were at times encouraged by supervisors to bypass getting informed consent from patients.

One student said that, if there was someone to blame, it was older members of staff.

"They're a dying breed," he wrote. "Hospitals used to be controlled by self-worshipping anxiety-riddled men who often prioritised their own egos over patient wellbeing."

Another female student described an incident where a supervisor acted inappropriately, but she could not speak up.

"One of my consultants got me to practise examinations with him in a closed room," she said. "He 'taught' exam techniques on my body, which I knew weren't part of the actual exam. It made me really uncomfortable, but because he was in such a high position, I felt like I couldn't stop him."

One account within the study describes a supervisor forcing a student to perform a rectal exam on an unconscious patient without consent.

"I felt like the medical school didn't care when I contacted them," he wrote. "Even senior staff were either unsure or unconcerned. I was essentially brushed off."

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

"I'd say that 99.9 per cent 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 call something out."

Other students echo this sentiment. "It sounds bad, but there's just no incentive to stand up to supervisors," wrote one fifth year student. "They won't thank you for it, and to be honest, the patient won't either."

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

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

Medical Sciences deputy dean Warwick Bagg said the university must do better.

"We're going to be working to ensure that this is done better," he said. "Informed consent is clearly set out and clearly taught. It needs to be done properly."

Bagg said the University of Auckland would work with hospitals to address students' concerns.