Medicus April 2016

O P I N I O N

The Office that isn’t an Office

Daniel Dorevitch President, Western Australian Medical Students' Society

W hen choosing a career in medicine or allied health, most students like to reassure themselves that they’ve truly escaped the “daily grind” of desk-job life. Avoiding a commute to St George’s Terrace, a lift to the 42nd floor and a nine-to-five manacle chaining you to a desk, we often like to think (and tell others) that we’ve chosen a nobler, more interesting and more intellectual career path. In some ways, this is actually true. Our days often don’t have regular hours; there is certainly very little time spent at any given desk or computer; and any “standard” shift can bear witness to the utmost highs and lows of humanity as we aid our patients’ journeys through the behemoth that is our place of work. What they don’t teach you in medical school though, is that the hospital ward is subject to as many problems and politics as a fraught CBD office and that navigating these can be a genuine challenge to any student. Ego-battles and turf warfare are disappointingly common, with large personalities (sometimes, but not always backed up with large job titles) asserting themselves over anyone who will submit. Though the arguments and tension that often abound on the ward are masked by the phrase “it’s in the patient’s best interest”, sadly it’s more often the case that what is playing out is a simple power relationship. One staff member is asserting themselves as the more influential, powerful or dominant in the relationship and challenging the other

to either fight or submit. It’s practically primeval. Sadly, as the proverbial bottom of the food chain, students are often highly vulnerable in a system that in some parts remains extremely hierarchical. Teaching through scare tactics, instilling deep-seated fear of failure through outright bullying and even sexual harassment are all still found on the wards. Personally I have been lucky throughout my journey in medical school. My consultants have either taught or simply ignored me, and the only noted benefit of my fast-receded hairline is that staff and patients assume I have both age and experience. Only the former is true. So in this context, I was dismayed to see results from a survey that WAMSS undertook last year, assessing the incidence and impact of sexual harassment on our UWA medical students. Nearly one fifth of respondents identified having experienced sexual harassment during their medical studies, the vast majority of whom having had this take place whilst on a clinical placement. Only one student had ever officially reported any harassment, and the majority felt they had never received any training or information on reporting procedures during orientation or induction. I don’t presume to suggest

Teaching through scare tactics, instilling

bullying and harassment in hospitals, though improved from decades past, still exists. Talking openly and often about this culture shift is the first step, and peer-led rather than paperwork-led condemnation of this behaviour is the second. As for our students: education early on that their new office (that isn’t an office) comes with all the trials of a regular place of work; encouragement to seek help and learn appropriate reporting avenues; and fostering a positive and team-centred approach are all good places to start. ■ deep-seated fear of failure through outright bullying and even sexual harassment are all still found on the wards

any magical solution to this problem. There is no doubt that the culture of

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