The effect of a global pandemic on the treatment of medical students during general surgery clerkship

Learner mistreatment is unfortunately deeply rooted in medical training. Despite interventions, the 2021 American Medical Colleges Graduation Questionnaire (GQ) continues to demonstrate approximately 40% of graduates reporting mistreatment. Unprecedented challenges related to the COVID-19 pandemic resulted in change and burnout across all sectors of healthcare delivery with unanticipated effects on the learning environment.

We sought to assess the incidence and nature of reported learner mistreatment amongst third year medical students on general surgery, comparing incidents before, during, and post-pandemic.

Clerkship evaluations and GQ for academic year 2019–2020, 2020–2021, and 2021–2022 were reviewed. Clerkship evaluations were de-identified and anonymized, focusing on mistreatment. GQ survey results for 2019, 2020, 2021, and 2022 were reviewed, focusing on negative behaviors and their source. Comparison of our institution to all medical schools was carried out.

Internal clerkship evaluations did not demonstrate increased rates of reported mistreatment during the pandemic. However, review of GQ data demonstrated an increased trend in the number of negative behaviors over the time periods, noting an increased number of complaints, as well as percentage of students experiencing mistreatment. The source was noted to be faculty and residents, but complaints related to hospital nursing staff increased. In comparison, national rates for these reports remained stable.

Institutional GQ data indicate an increase in negative behaviors experienced by learners over the past 3 years during the COVID-19 pandemic, with increased negative behaviors from hospital staff. The pandemic appears to be having lingering effects on all aspects of healthcare delivery and the true clinical implications may not be apparent for several years into the future.