• Tamara K Oser, Paul Haidet, Peter R Lewis, David T Mauger, Dennis L Gingrich, and Shou Ling Leong.
• Dr. Oser is assistant professor of family and community medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. Dr. Haidet is director of medical education research and professor of medicine, humanities, and public health sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. Dr. Lewis is professor of family and community medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. Dr. Mauger is professor of public health sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. Dr. Gingrich is professor of family and community medicine and humanities, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. Dr. Leong is associate vice chair for education, predoctoral director, and professor of family and community medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
• Acad Med. 2014 May 1;89(5):755-61.

PurposeAccording to responses to the Association of American Medical Colleges' Medical School Graduation Questionnaire, 17% to 20% of medical students report mistreatment. This study examined the longitudinal nature of medical student mistreatment based on specialty choice.MethodFrom 2003 to 2010, the authors surveyed all medical students at one institution at the end of their third year, assessing the frequency and impact of any mistreatment based on specialty choice. They analyzed quantitative data on the frequency, impact, sources, and trends over time and qualitative data from students' open-ended responses and compared data by specialty interest (primary care versus subspecialty).ResultsOf the 1,059 students sent the survey, 801 (76%) responded. Mistreatment based on specialty choice was common. The frequency and impact of such mistreatment were tightly correlated (Pearson r = 0.8, P < .001). The nature of mistreatment differed between students interested in primary care and those interested in a subspecialty, occurred more commonly on specific clerkships, and originated most often from resident physicians. Students perceived that teaching opportunities and evaluations were negatively affected by their specialty choice. An association was found between the theme of respect and students reconsidering their specialty choice. These patterns of mistreatment were stable over the study period, despite several professionalism initiatives.ConclusionsMistreatment based on specialty choice is a distinct and common phenomenon perpetuated by faculty, residents, and peers. More research is needed to explore the potential hidden curriculum drivers of these findings and to develop interventions specifically targeting this type of mistreatment.

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