Shouting at student physicians is still a thing.

Justified as “teaching by humiliation.”
It is the worst form of “teaching” I have ever encountered.

Being asked questions aggressively,
Being ridiculed if you get the answer wrong,
Being shouted at, scolded.
All in front of other students, colleagues, and patients.

It’s embarrassing, undermining, and it crushes confidence.
It silences your voice.
Makes you question yourself.
Makes you want to cry.

It’s disempowering.

Almost 20 years later, I still remember it.
Six of us, wearing lab coats, huddled around a patient in bed.
He was an elderly cardiology patient.
I was presenting his case to Dr. S, the consultant.
Dr. S was responsible for our learning that week.
He asked me about the cellular disease process of the patient’s condition.
I got the answer wrong.

Boy, did he make sure I’d never forget.

He shouted at me.
Called me stupid.
Asked me how I ever expected to become a doctor.

I went numb. I froze.
His face was contorted with anger.
I just kept saying sorry.

The patient looked confused.
Everyone else looked down at their shoes.

Dr. S shrugged.
He moved on to the others:
“Do any of you actually know anything?”
He said nothing more to me for the rest of the week.

I felt so small.
Like I didn’t belong in medical school.

It wasn’t a one-off.
This kind of thing happened all the time in medical school. And at work.
A common “teaching” method.
It just became normal. Acceptable.
“That consultant is like that, but you’ll end up learning loads,” people said.

But this isn’t true.
Quite the opposite in fact.
Teaching by humiliation doesn’t “maintain high standards,”
Or “prepare you for high-pressure situations.”

It’s bullying.
Poorly disguised as “teaching.”
It’s abuse.

It’s usually carried out by physicians with authority,
Consultants, clinical supervisors, assessors.
You don’t feel able to speak up about it because of their seniority,
And deeply entrenched hierarchy.

If you do speak up, you risk being labelled as over-sensitive, soft.
Unable to take a joke.
You risk more bullying.
You risk being given a fail.

It sounds extreme, all these consequences.
But it’s true. Ask any physicians.
I guarantee they will have experienced similar, at some point in their career.

What shocks me is that it’s still happening.
A 2024 meta-analysis looked at the experiences of 35,000 student physicians worldwide.

Up to 90 percent of them experienced teaching by humiliation.

It also showed that this form of “teaching” is associated with mental health problems in medical students:
Depression, anxiety, stress, burnout, substance abuse, suicidal ideation.

Why is it still happening?
What’s the response of medical education leaders? Of medical schools?

Physicians have hearts too.
We deserve to learn in safe environments,
To be treated with respect.

Patients deserve confident physicians,
Who are empowered to ask questions,
Seeking help when they need it, to ensure safe care.
This doesn’t happen through “teaching by humiliation.”

Seema Pattni is a physician coach.