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December 7, 1984

Medical Student Abuse

Author Affiliations

Mill Valley, Calif

JAMA. 1984;252(21):2958-2959. doi:10.1001/jama.1984.03350210014011

To the Editor.—  Rosenberg and Silver1 discuss the problem of verbal abuse in medical education. As a psychiatric educator, I agree that verbal abuse demeans and demoralizes medical students and undermines their self-esteem and effectiveness.Other stresses may also impair medical students' health and learning. Verbal abuse may be just the tip of the iceberg—an educational system that injuriously exploits clinical trainees. Training schedules routinely deprive medical students and residents of the time they need for sleep, exercise, and social relationships. Trainees are often required to remain awake for 36-hour shifts and to work more than 100 hr/wk. Much of the work, such as running errands and holding retractors, may have little to do with learning medicine. Already heavily indebted, many trainees feel obligated to meet graduation requirements to be able to work and repay their loans. These stresses fatigue, frustrate, and depress many students. In this context of