Prevalence and Determinants of Academic Bullying Among Junior Doctors in Sierra Leone: Cross-Sectional Study.

Abstract

Background: Academic bullying among junior doctors-characterized by repeated actions that undermine confidence, reputation, and career progression-is associated with adverse consequences for mental health and professional development.

Objective: This study aimed to investigate the prevalence and determinants of academic bullying among junior doctors in Sierra Leone.

Methods: We conducted a cross-sectional survey of 126 junior doctors at the University of Sierra Leone Teaching Hospitals Complex in Freetown between January 1 and March 30, 2024. Participants were selected through random sampling. Data were collected using a semistructured, self-administered questionnaire and analyzed with descriptive statistics and multivariable logistic regression.

Results: Of the 126 participants (n=77, 61.1% male; mean age 31.9, SD 5.05 years), 86 (68.3%) participants reported experiencing academic bullying. Among those, 55.8% (n=48) of participants experienced it occasionally and 36% (n=31) of participants experienced it very frequently. The most common forms were unfair criticism (n=63, 73.3%), verbal aggression (n=57, 66.3%), and derogatory remarks (n=41, 47.7%). Consultants and senior doctors were the main perpetrators, with incidents primarily occurring during ward rounds, clinical meetings, and academic seminars. No statistically significant predictors of bullying were found for gender (odds ratio 2.07, 95% CI 0.92-4.64; P=.08) or less than 2 years of practice (odds ratio 0.30, 95% CI 0.05-1.79; P=.19).

Conclusions: Academic bullying is widespread among junior doctors at the University of Sierra Leone Teaching Hospitals Complex. It has serious consequences for their mental health and professional development. There is an urgent need for clear and culturally appropriate policies, targeted training programs, confidential reporting systems, and leadership development. Promoting ethical leadership and fostering a culture of respect can help reduce incivility and burnout, leading to a healthier work environment for junior doctors.