The Bullying Medical Professors

This article would be best enjoyed if the reader takes pains to read first, an article by a foremost colleague then, proceed with this one which serves as a mere rejoinder to the said article. It was first published in The Nigerian Health Journal .

Click on the link below to read it:
http://nigerianhealthjournal.com/?p=1288
EXTENT OF THE PROBLEM
Since I attended the same medical school as the said author, may I, solemnly decrypt his comments by mentioning some names here! The encrypted bullying Professors, by no means the only inveterate bullies in those days, were...Surgery,Adebonojo; Internal Medicine, Akinyanju: Paediatrics, Olikoye Ransome- Kuti: Obstetrics and Gynaecology, Agboola, the worst of them all nicknamed Gaddaffi!.

A bit disappointing that the author forgot to mention "Mama Anaesthesia", Professor Dorothy Ffouls- Crabbe ....who took the art of bullying to another level. She habitually gave us vicious knocks on our heads, delivered vigorous twists to our ears, before asking us to go kneel down in front of our huge lecture hall, close our eyes, and raise up our arms! My encounter with her one fateful day in the dental theatre was not funny.

You see, children are routinely given general anaesthesia before painful dental procedures including extractions....And in her opinion, I was not careful enough with the patient's airway. With a deafening shriek, she yelled "Akindele, Akindele, you never leave the airway of the patient!"...then proceeded to turn my skull into a conga drum as she rained vicious knocks on my head! I lost count.

My eyes turned deep red. Nurses in attendance exchanged quick anxious glances. We were senior clinical students in our penultimate years of training....when our mates who did shorter courses had already graduated!. Olikoye Ransome Kuti might have gained prominence as a doctor but he was a poor teacher. The lager beer incident mentioned by the author was not the only time he demonstrated bad judgment. I lost my cool with Professor Esho though...

He was on full throttle bullying me right there in the exam "hall"...and I told him that the onus was on him to put me at ease, that an examination is a two- way process and that he should take it easy with me. I refer to practical/ clinical exams and I knew that by my restrained outburst, he was going to fail me! You fail the clinicals, then automatically fail the whole exam no matter your scores in the essay and multiple choice questions (MCQ) papers.

We had to grapple with negative marking in the MCQs in which some student scores raked in negative integers, so why should the man add to my problem! So I graduated years later, quite behind my classmates. In my whole academic career, it was only my medical school that found me "dull". A compulsive star on prize- giving days in primary and high school where I even won a full scholarship, it is as if I again rediscovered my intellect after graduation!

FACTORS THAT PERPETUATE THE PROBLEM.
Though Professor Ffoules Crabbe's novel approach to bullying was deserving of psychiatric intervention, none of us had the courage to lodge an official report with the college authorities in spite of the obvious illegality of her actions....afraid that her colleagues....in solidarity with her...would fail us perpetually and prevent us from graduating! What could we do? Report the bully and have his colleagues mark us down and ensure we never graduated?

The only time I protested, I payed dearly for it in years...as I already stated! Friends and family started calling our mothers "Mama Doctor" the very day we got our admission letters from JAMB and disappointing such proud parents by withdrawing from the course was the last thing on our minds! I think there is more awareness now. But we still have a long way to go. I thought I had forgotten it all only for the said author to make it all rush back!

I think the situation was rampant because there were no checks and balances. Afterall, there was a smattering of good ones among our medical teachers. As the term suggests, the good ones were abysmally few. And if these ones chose to be bad, there was practically nothing by way of sanctions anyway. And so, many academic talents were wasted....required to withdraw from the course for excuses ranging from the flimsy....through the sublime....to the ridiculous. Individual who undoubtedly, could have turned out to be brilliant doctors....perhaps much better than those of us who survived the whole mess!

Besides, there is an element of ego. How do you tell a young man who has never "carried" the second position in his academic life that he has failed an exam...often repeatedly...and for some lousy technicalities.....or lecturer idiosyncracies?How do you mend his injured ego so that he does not fail endlessly? Realising that an ego-fix might come in handy in my case, I read compulsively after graduation. I re- read all my medical books right from year one!

CONSEQUENCES OF BULLYING.
The sad thing is that, as already stated by the author, bullying has the tendency to be a generational thing. A victim of bullying may transform into one of these...

1. Become a bully to those weaker than him...
2. Become perpetually docile and unassertive....
3. Become overassertive and inanely aggressive.....

4. Become homicidal as he takes immediate carefully- orchestrated steps to kill his tormentors.

For me, it was triple tragedy....bullied by step- mother at home, bullied in high school where I probably hold the title of the most- beaten up pupil in the history of the school....then when I finally thought I had a respite, beaten up again by Professors as a clinical medical student!

SOLUTIONS PROFERRED.
Bullying or any other social vice does not just solve itself. The society at large, and the medical community in particular, must take concrete steps to solve it. The first step of course, is to recognise it as a problem....followed by a determined attempt at solutions. I hereby proffer the following solutions:

1. Victims of bullies should summon the courage to lodge official reports.

2. Responsible officials should treat such report with the seriousness it deserves.

3. Psychological and psychiatric treatment should be provided for officers who require such. Teachers at all levels must be made to undergo regular psychiatric assessment to ascertain their continuing suitability for the job of teaching.

4. Residents and others who are future university teachers must undergo some courses in the faculty of education. It should not be assumed that once an individual possesses a postgraduate qualification, he can teach the subject in question.

Like I often say, teaching is a profession and its skills need to be taught. Post- graduate medical students (residents) who are future medical tutors must temporise in a nearby faculty of education. We must refrain from the folly of assuming that once an individual possesses a PhD or some fellowship diploma, he can automatically function as a teacher in his core area of interest! Some persons simply lack the temperament and the gumption to teach!

5. Educational institutions must subject their students to regular mandatory evaluation of their teachers using annonymous forms so designed as to place as much emphasis on academic content as student- lecturer relationship and the attitudinal cum behavioural attributes of teachers! The worth of a teacher resides in bringing out the brilliance in his students....notin the number of students he can fail!

6. We must not forget to mention that more emphasis be placed on the fact that teachers especially in secondary schools need to be psychologically ingrained. Thank God my immediate younger brother is a professional teacher....went through all the works....Grade 2....then NCE....followed by a university degree in education. A good teacher would curiously explore the family background, family mechanisms cum dynamics and family machinations of his student....among other things.....

7. We have a culture of child abuse. This is to be discouraged! It is not uncommon for parents to inflict more beatings on kids for having the "audacity" to report to them that they were beaten by teachers at school!....a phenomenon so endemic that our university professors now strike out at their students! Steps already put in place by our state governments to curtail child abuse and battery are commendable. They should be improved upon.

8. I remember reading a book on Surgical Residency (i.e. postgraduate training in surgery) in the US. Bullying of subordinates would in the first instance, attract a verbal counselling, followed by a verbal reprimand, then caution in writing, and finally, summary dismissal from the program! We must imbibe such techniques.

9. There are three purviews of learning....cognitive, affective and psychomotor....as you would readily recall. It is for the essence of placing more emphasis on the affective cum attitudino- behavioural domains that medical degrees are not strictly categorized into 1st class, 2nd class and so on. Everybody is given a pass degree except, occasionally, there is the need to return a candidate as having passed with distinction. The term "Pass" is in fact reserved for the final award of a medical degree. Prior to that ultimate point, our exam results bore the phrase...."Satisfied The Examiners". Medical professors hide under this loose phrase to commit atrocities.....like visiting students with "Veto Fail" exam results. All the man needed to say was that this or that particular student, would not, in his own opinion, be worthy of being admitted into the profession! Medical teachers must be discouraged from being so disposed. Such loose terms as "satisfied the examiners" must be expunged for "pass".

10. Achaic subjective examination methodologies like The Long Case should be totally replaced with the OSCE (Objective Structured Clinical Examination). Medical teachers ought not to retain subjective exam methods so they may manipulate exam results.

Having been thoroughly bullied as a child by teachers, school principals, physically stronger classmates, parents and relatives, you can imagine what type of adult I would turn out to be. In the formative years of a child, it is like a script being written in indelible ink.

CONCLUSION (Respondent)
Now that you mentioned it Tosin, I might as well comment on it: I never thought we could end up 'pallying' like this. In school, I saw you as overly assertive and quite aggressive to borrow your own words. I could sense some innate anger. I remember in particular an altercation between you and a friend and how I got part of the "punch". I'm glad you've come to terms with it or we won't be having this discussion. That is a healing process. Tosin, honestly having lived in the West for quite some time, I have come to understand the destructive nature of bullying. I have come to understand that children who exhibit rebellious traits are to be understood and helped.

The problem usually goes back to the childhood. At least it was your own stepmom. My own mum was always so quick with the slap, I became so rebellious. With hindsight it was a function of her domestic frustration. I don't even think African parents see it as abuse. Nonetheless, we can't afford to carry hate along, but we can keep on speaking out against the vice of bullying. A little bit here, a little bit there will eventually add up and hopefully make a difference in awareness.

It's a deep-rooted problem. A lecturer giving head knocks to a doctor in training! It's not even funny! Nigeria is a pretty rough terrain to grow up in, a wilderness where only the fittest survive. Consequently, aggression instinctively becomes our nature. There's so much frustration in the people and naturally it is the vulnerable who suffer. What with utterly unresponsive leaders. Very sad. Thumbs up to you for ANALYTICAL MINDS!

Dr Tosin Akindele is a Lagos -based medical practitioner