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Policy Statement Aims to End Bullying Culture in Cardiology

Action must be taken to stamp out bullying in hospital cardiology departments, professional bodies said.

The British Junior Cardiologists' Association (BJCA) and the British Cardiovascular Society (BCS) issued a joint position statement in the journal Heart after figures showed that inappropriate behaviour was commonplace in cardiology teams. 

Damaging to Mental Health and Harmful to Patient Care

The umbrella term was used to describe unprofessional and unacceptable behaviours that included bullying, discrimination, harassment, and inappropriate language that was sexist, racist, or homophobic towards other team members. Such behaviour impacted on individual wellbeing, mental health, and performance, and put patient care at risk, both organisations warned.

Inappropriate behaviour could also harm recruitment and retention of staff across the cardiovascular workforce particularly among women who were already under-represented in the speciality.

Members of the cardiovascular workforce were "entitled to work in an environment where appropriate and professional behaviour is the expected standard and episodes of inappropriate behaviour are not tolerated, but challenged when they occur", according to the statement, which was endorsed by 19 organisations affiliated with the BCS.

A 2021 study in Heart found that out of 1358 cardiology trainees surveyed, 11% reported bullying, with women 55% more likely to report being victimised. And figures from the General Medical Council's national training survey suggested that bullying in cardiology was almost double the average across all medical specialties (12.3% vs 6.9%). Further evidence from trainees suggested that both sexist and racist language were common in cardiology departments.

Inappropriate behaviour was also frequently experienced at consultant level, with 20% reporting being bullied or harassed, and 35% reporting feeling undermined at work, the statement reported.

According to the societies, a culture of bullying might reflect how cardiologists were trained in the past, and was based in an "anachronistic and flawed" notion that it helped to "build character".

Strategies for Tackling Inappropriate Behaviour

Recommended strategies at the individual and departmental level to improve the culture within UK cardiology included:

  • Setting out clear standards and expectations of behavioural norms from all members of the cardiovascular team
  • Encouraging reporting of inappropriate behaviours
  • Designating and training an individual with whom concerns over behaviour could be raised
At national level, strategies included:
  • Developing a positive organisational culture and ensuring that similar standards of behaviour were expected from members of national bodies
  • Establishing a transparent cardiology reporting strategy for inappropriate behaviour
  • Taking into account incidences of inappropriate behaviour when allocating funding and advancement in cardiovascular research

Professor John Greenwood, president of the BCS, said the statement and recommendations represented "a concerted effort to stop bullying in its tracks and put measures in place to stop it happening in the future". 

Dr Christian Fielder Camm, BJCA president said that "all those involved in UK cardiology and cardiovascular medicine have a responsibility to face up to this longstanding problem".