Title: Instruction through Humiliation: The Lasting Damage of Medical Mistreatment
Within the confines of hospital hallways, clinical teaching spaces, and busy patient rooms, a challenging and detrimental teaching technique lingers in the sphere of medical education: “instruction through humiliation.” Often hidden behind the facade of discipline, rigor, and professional standards, it encompasses yelling at, ridiculing, and diminishing student doctors—frequently in front of others and with harshness. Despite advancements in technology, procedures, and evidence-based practices in medicine, the culture of humiliation remains deeply embedded in the training landscape. For numerous trainees, it inflicts enduring psychological damage and undermines the core principles of compassionate, capable medical practice.
A Climate of Shame
“Why are you not aware of this? How do you plan to become a physician?” This statement, yelled at a student before a patient, continues to resonate in Dr. Seema Pattni’s mind two decades later. Her ordeal is all too familiar to countless generations of doctors. Even while dressed professionally and well-prepared, she and her peers frequently faced public reproaches framed as learning moments.
This behavior has become so widespread that it has normalized. New students are cautioned in hushed tones: “That’s just Dr. X’s teaching style—you’ll learn a lot, don’t take it to heart.” However, what they are learning, in addition to clinical knowledge, is that intimidation is permissible, fear is anticipated, and silence is preferable to the admission of doubt.
Shame as “Education”
Instructing through humiliation often entails being subjected to aggressive, rapid-fire questioning (a practice known as “pimping”), facing corrections infused with sarcasm or mockery in front of peers and patients, and being told that one’s inadequacies invalidate their place in the field. Advocates for this approach may claim it equips students for high-pressure medical scenarios or eliminates those who “can’t withstand the stress.”
Yet, mounting research indicates that rather than fostering resilience, this technique results in heightened anxiety, emotional withdrawal, burnout, and feelings of being a fraud. The learner who faces humiliation fails to grasp the intended lesson; instead, they absorb the insult.
The Burden of Authority
What renders this behavior particularly challenging to confront is the entrenched hierarchy within medical institutions. Attendings, specialists, and supervisors possess significant power—not just regarding student education but also concerning evaluations, references, and future career trajectories. Lodging a complaint against a senior physician can have negative repercussions, labeling the student as fragile, overly sensitive, or troublesome. The consequences may be subtle yet impactful: diminished learning prospects, unkind evaluations, and unseen career barriers.
“The danger lies not only in the act of speaking out,” notes Dr. Pattni, now a physician coach. “The true risk is in navigating this system as a learner who is already vulnerable, under significant stress, and feeling that their very presence is unwelcome.”
A Global Crisis
Regrettably, this is not just a localized phenomenon. A 2024 meta-analysis surveying over 35,000 student doctors from around the world found that nearly 90% had encountered some form of teaching through humiliation. The psychological impact is evident: elevated levels of depression, anxiety, stress, substance abuse, burnout, and even suicidal thoughts among medical students and residents.
This frequency of mistreatment is not merely ethically troubling—it represents a public health issue.
The Ripple Effect on Patient Care
In a punitive learning atmosphere, students learn quickly to conceal their knowledge gaps. Being incorrect is perilous. Requesting assistance is fraught with risk. Over time, this environment produces professionals who fear appearing weak rather than those encouraged to be inquisitive, humble, and secure.
The repercussions for patient care are significant. A physician burdened by internal doubt or fear of humiliation may hesitate to express concerns in rounds, consult a colleague, or advocate effectively for a patient. The strength of contemporary medicine relies not on knowing everything, but on recognizing when to inquire, when to verify, and when to admit, “I’m uncertain.”
A Required Reckoning
Why does this archaic method continue to persist in a field so anchored in evidence and advancement? Partially due to a medical culture that resists self-examination: if “I endured it,” the reasoning follows, “so should they.” This represents intergenerational trauma disguised as mentorship.
However, change is both necessary and attainable. Institutions can start by:
– Implementing feedback systems that allow students to report mistreatment without fear of consequences.
– Assessing faculty based on their teaching methodologies, not solely their clinical skills.
– Offering leadership training that emphasizes emotional intelligence and psychological well-being.
– Integrating mental health resources and wellness initiatives throughout training.
The Path Ahead
It’s time to dismantle the fallacy that humiliation creates resilient doctors. That being yelled at enhances clinical reasoning. That shame propels excellence. None of this is corroborated by evidence. What becomes clear, however, is that a toxic educational setting diminishes spirits, stunts growth, and jeopardizes patient safety.
Physicians are not machines. They are individuals with emotions—the very same emotions required to engage with empathy toward their patients.