What is Mistreatment?
Mistreatment is generally defined within the medical education context as intentional or unintentional behaviour that shows disrespect for the dignity of others. Mistreatment can involve a single incident or a pattern of behaviour and can range from subtle gestures and/or comments to egregious actions. Any behaviour involving the mistreatment of another person compromises the learning environment.
Mistreatment includes ‘micro-aggressions’, which are often unintentional, but experienced as a pattern of, snubs, slights, put-downs, and gestures that demean or humiliate individuals based on their belonging to a group, particularly those identified by gender, race/ethnicity, sexual orientation, immigration status, and/or socioeconomic class.
The Temerty Faculty of Medicine recognizes as harmful all of the behaviours and actions that are deemed unacceptable under one or more of the statements, policies, protocols, codes and standards referenced above and listed in the Student Mistreatment Protocol and the PGME Guidelines for Managing Disclosures of Learner Mistreatment.
Categories and Examples of Mistreatment
Mistreatment can be categorized in numerous ways. In the MD Program Student Mistreatment Protocol and the PGME Guidelines for Managing Disclosures of Learner Mistreatment, mistreatment is categorized as outlined below.
Behaviours that fall under the discrimination and discriminatory harassment and sexual violence and sexual harassment categories are considered unprofessional. However, they are considered discrete mistreatment categories since they are defined and addressed through specific U of T policies as well as the Ontario Human Rights Code.
The examples provided below are not exhaustive and are not intended to represent the spectrum of behaviours that may be considered mistreatment. If you are unsure, we encourage you to get in touch through the disclosure form.
Unprofessional Behaviour
Selected examples:
- required to perform personal services
- publicly humiliated, implicitly (e.g. eye-rolling) or explicitly
- subjected to recurring outbursts of anger (e.g. shouting, throwing objects)
- subjected to disparaging remarks about the character or patient care of another physician/health professional/learner
- inhibited by a person in authority from providing appropriate feedback/evaluation, including disclosures or reports of mistreatment
- subjected to retaliation in response to a disclosure, report and/or investigation of mistreatment
- threatened with physical harm
- physically harmed
- faced issues related to academic integrity or research integrity
Key policy documents:
- CPSO Physician Behaviour in the Professional Environment and Guidebook for Managing Disruptive Physician Behaviour
- CPSO Professional Responsibilities in Undergraduate Medical Education
- Faculty of Medicine Standards of Professional Behaviour for Clinical (MD) Faculty
- U of T Standards of Professional Practice Behaviour for all Health Professional Students
- MD Program Guidelines for the Assessment of Student Professionalism
Discrimination and Discriminatory Harassment
Selected examples:
- subjected to offensive remarks/names related to or based on race, ethnicity, gender, sexual orientation, religion or any of the other protected grounds identified in the Ontario Human Rights Code
- denied opportunities for training or rewards based on any of the protected grounds identified in the Ontario Human Rights Code
- received lower evaluations/grades based on any of the protected grounds identified in the Ontario Human Rights Code
- denied and/or subjected to critical, dismissive or demeaning remarks about approved academic accommodations (e.g. time to perform a smudging ceremony, pray, commemorate religious observance)
- not provided with reasonable academic accommodations
Key policy documents:
Sexual Violence and Sexual Harassment
Selected examples:
- subjected to offensive sexist remarks/names
- subjected to sex-related comments about my/someone’s physical appearance or actions
- subjected to unwanted sexual advances
- asked to exchange sexual favours for grades or other rewards
- inhibited by a person in authority from reporting unwelcome sexual comments or unwanted sexual advances
Key policy documents: