By Jonnelle Marte

How a spoonful of bullying, plus a heaping pile of debt, helps turn students into doctors.

By the time most medical school students are assisting in hospitals shadowing the doctors they aspire to someday become many are well-accustomed to being pushed around, yelled at, or called derogatory names.Such incidents arent new, but with the med student population only growing (admissions are up 17% since 2002, with schools working to address a projected shortage of 90,000 doctors by 2020), cracking down on the problem has becoming a matter of increasing urgency. Especially in cases of more severe abuse: A survey conducted this year by the Association of American Medical Colleges, or AAMC, 33% of students said they were publicly humiliated at least once during medical school, 15% said they were the object of sexist remarks and 9% said they were required to run errands for doctors.

And a study released this year by the David Geffen School of Medicine at UCLA found that despite several efforts by the school to hold bullying awareness workshops for third-year students (who bear the brunt of the mistreatment, because thats when they begin working in hospitals with medical residents and doctors) and to warn residents and teachers about the consequences of such actions, the abuse has persisted, with more than half of students surveyed between 1996 and 2008 reporting some form of mistreatment. Part of the problem, says Joyce Fried, assistant dean at the school of medicine, is that even though the school takes steps, such as waiting until after grades are awarded before launching investigations, to prevent retaliation toward students who come forward, many are still afraid to do so.

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For its part, the AAMC is trying to keep an eye out for abuse: When students finally graduate from medical school, the AAMC typically sends them a questionnaire, which it recently updated to ask more specific questions about bullying. Additionally, president Darrell Kirch posted a letter to the AAMC website in September expressing concern that exposure to bullying could negatively impact a doctors future interactions with patients.

Student advocates say they also worry that such treatment often squelches a students desire to enter the field or worse yet instills a sense of fear among young doctors that could prevent them from challenging colleagues when errors are made or from trying new approaches to improve care. Theyre overworked and treated unkindly by people who are supposed to be teaching them, says Diane Pinakiewicz, president of the National Patient Safety Foundation, adding that those doctors often go on to mistreat other students when they begin to teach. Were trying to break the cycle.

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10 things medical schools won’t tell you