Sharp Scratch How to navigate the hospital hierarchy as a medical student
Apr 17, 2025
Lorelei Jones, a medical anthropologist and senior lecturer at Bangor University, shares insights on navigating the complex hierarchy within healthcare. She discusses the challenges junior doctors face in advocating for patient safety in a system that can stifle their voices. The conversation highlights the shift towards more collaborative, patient-centered care post-COVID, emphasizing the importance of psychological safety and open communication. Lorelei also encourages empowering medical students to speak up and voice concerns, fostering a healthier work environment.
AI Snips
Chapters
Transcript
Episode notes
Hierarchy as Control in Medicine
- Hierarchy in medicine functions as a mode of control backed by formal authority and sanctions, like job loss.
- It has persisted due to the complexity and size of publicly funded healthcare like the NHS.
Harmful Effects of Punitive Hierarchies
- Hierarchies practiced coercively or punitively cause psychological harm and constrain moral actions.
- This negatively affects patient safety and creativity in healthcare.
Junior Doctors Feeling Powerless
- Junior doctors feel responsible but powerless to change established ward cultures during rotations.
- Stories of raised concerns being ignored discourage speaking up at the bottom of the hierarchy.