Attending physicians and residents rely on each other to add depth and breadth to the continual educational endeavor that medical professionals are engaged in, as well as to enhance the care they provide to patients. Whether consciously or not, the conduct of attending physicians influences how residents act and behave with colleagues and their patients. Unfortunately, unprofessional behavior is also contagious. Residents who are asked under coercive circumstances to do personal chores and errands are likely to perceive the requests as unjust rather than collegial. Unfortunately, faculty who place such demands on residents may have lost touch with the moral foundation that underpins their role.
Confusion is understandable.
In medicine, as perhaps in other professions, a destructive hidden curriculum may be emerging, one that is motivated by monetary values and in which residents are seen as simply attending-helpers. Finally, given the apparent widespread nature of the described patterns, this institution appears to have failed in meeting its stewardship obligations for graduate medical education. The CEO or dean may need to assemble the faculty to reflect on appropriate expectations and practices and to institutionalize them. Residents should consider procedures established by the Accreditation Council for Graduate Medical Education to deal with complaints against residency programs. Whether an intervention would have occurred promptly enough to relieve the resident from the task of painting, it would have helped the institution to refocus on the true meaning of the mentoring relationship that should guide attending and resident physicians.