23 April 2019

Dr Matthew Clarke of our Trainee Advisory Committee outlines the College's plan to address bullying and harassment in pathology

Bullying and harassment is not a new problem. Most junior doctors will either have experienced, witnessed or know of an incident of bullying in the workplace. Unfortunately, partly due to their frequency, it has become ingrained in the culture of training to accept such occurrences, keep your head down, get on with your work and you will eventually come out on the other side.

However, bullying and harassment are completely unacceptable in any working environment and at any grade. Sadly, the General Medical Council’s trainee survey of 2017 showed that pathology is not immune. There were 31 reported occurrences, but regrettably not a single trainee was prepared to provide further details. 

A culture of anxiety

There is a culture of anxiety that if you try to tackle the problem, you are putting career progression at risk. Although there are relatively few incidents in pathology compared with elsewhere, even one is unacceptable. The time has come for organisations to ensure that robust policies and support are in place to help trainees who find themselves in such challenging situations make that brave first step of reporting an incident.

Bullying and harassment can take many different forms – they can be both physical and verbal, and can occur via email and social media. They can be isolated incidents or a persistent issue. The repercussions for the individual cannot be underestimated: lack of confidence and anxiety can impact on a trainee’s ability to work or train effectively, and may also compromise patient safety. If one member of the team is affected, it can also negatively impact on others.

Our plan of action

The College is extremely concerned that bullying and harassment is still a feature in pathology training, and has taken a proactive approach to ensure that this is eliminated. After discussion at the College’s President’s Group, a more strategic and comprehensive approach to bullying has been developed with the Trainee Advisory Committee (TAC), which has been presented to College Council. The actions include:

  • The College should endorse the ‘Let’s Remove It’ campaign of the Royal College of Surgeons (Edinburgh), adopting a shared commitment to the campaign with the hope that other sister organisations will take a similar approach. Since its launch in June 2017, the aim of the campaign has been to lead cultural change across all healthcare professions and it has implemented activities and events to help achieve this.
  • The Royal College of Obstetricians & Gynaecologists hosted a free event on Thursday 4 April, aimed at clinicians and NHS managers to share best practice, interventions and solutions around bullying and undermining. Heads of pathology school and training programme directors of the various pathology specialties were encouraged to organise representation at the event. The TAC was represented; details will be reported in a future issue of the Bulletin.
  • The College, through the TAC, is developing a ‘Not in the Textbooks’ conference, which will include sessions devoted to this issue.
  • A pack of slides will shortly be available for College members and trainees to use to highlight the issue at conferences and meetings.
  • The RCPath website is being developed to include clear and consistent messaging about the College’s position and the resources available.
  • The issue of bullying will feature on the College’s professional development blog series written by Dr Chris Tiplady.

There is no ‘quick fix’ solution to this problem, but the above measures will hopefully result in all staff in pathology feeling that they are being supported and that help is available. It is important for us all to take time for self-reflection and think about the impact of what we say and do on those around us. We may perceive that we are behaving in a reasonable way, but would those around us agree? By talking about this important issue, ensuring that management policies are effective, and by promoting self-reflection, we should be able to change this culture and ensure a happy and healthy working environment for all.