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Creating a Positive Work Environment

The Royal College of Physicians and Surgeons of Canada believes that positive workplaces are a critical component to a successful medical education and care system in Canada. However, there is a great deal of evidence regarding mistreatment (including physical and verbal bullying, discrimination, and sexual or personal harassment) in environments where physicians train, learn or work. Anyone can be a perpetrator or a victim of mistreatment – including patients, physicians, and other providers.

The Royal College wishes to be explicit in its stand that Mistreatment is unacceptable in all of its forms; medical learning and work environments should be safe places for patients, physicians, and other health care providers. This is in line with the expectations of the Canadian Medical Association Code of Ethics and Professionalism, which the Royal College has adopted.

It is important to recognize that mistreatment covers a broad range of unacceptable behaviours, from belittlement and humiliation to grievous acts of sexual harassment and physical assault. Mistreatment is further described at the end of this statement. The Royal College acts to foster positive work and learning environments through accreditation for learners and its own policies for employees and volunteers.

It is important for all parties to be supported and protected when facing mistreatment. In particular, victims must know that they will be protected and not experience negative consequences when they disclose their experiences.

At the same time, those who are required to provide difficult feedback, or to manage difficult situations, should know that they can do so without risk of consequences when they are respectful, constructive and do not exhibit unprofessional behaviour.

We remain committed to nurturing positive work and learning environments and working with others to reach that goal.

We will reach out to leaders in learning and practice environments to curb mistreatment, and promote positive and safe places for learning and work.

Mistreatment explained

Broadly speaking, mistreatment encompasses various types of harmful behaviours. One single incident, if sufficiently serious, can constitute mistreatment in any of its forms.

While the list below is not comprehensive, it describes various types of mistreatment to inform discussion and action.

Bullying

Repeated, unreasonable, habitual and unwelcome behaviour directed towards a person or group. Bullying can occur one on one, be directed towards a group of people, or can happen in a group(s) of people. If bullying is done by a group, it is called mobbing. There are many different forms of bullying.

Cyber-bulling - The use of communication technologies such as the Internet, social networking sites, websites, email, text messaging and instant messaging to repeatedly intimidate or harass others. Cyberbullying includes (but is not limited to):

  • Sending mean or threatening emails or texts/instant messages;
  • Posting embarrassing photos of someone online;
  • Creating a website to make fun of others;
  • Pretending to be someone by using their name, image, or other identifying information; and
  • Tricking someone into revealing personal or embarrassing information and sending it to others.

Cyberbullying affects victims in different ways than traditional bullying. It can follow a victim everywhere 24 hours a day, 7 days a week, into their home - usually safe from traditional forms of bullying.

Physical bullying - Using your body or objects to cause harm. Includes hitting, punching, kicking, spitting, or breaking someone else's belongings.

Social bullying - Using relationships (family, friends, etc.) to hurt someone, including spreading rumours, gossiping, excluding others from a group or making others look foolish or unintelligent.

Verbal bullying - Using words to hurt someone. Includes name calling, put-downs, threats and teasing.

Discrimination

An action or decision that results in unfair or negative treatment of a person or group. There are 11 grounds of discrimination that are protected under the Canadian Human Rights Act:

  • Race
  • National or ethnic origin
  • Colour
  • Religion
  • Age
  • Sex
  • Sexual orientation
  • Marital status
  • Family status
  • Disability
  • A conviction for which a pardon has been granted or a record suspension has been ordered

Harassment

Harassment is a form of discrimination. It involves any unwanted physical or verbal behaviour that offends or humiliates. Generally, harassment is a behaviour that persists over time. However, one single incident, if sufficiently serious, can constitute harassment.

Personal harassment - Engaging in a course of vexatious comments or conduct not related to a prohibited ground, which creates an intimidating, humiliating, hostile or offensive work environment.

Personal harassment can include:

  • Spreading malicious rumors, gossip, or innuendo;
  • Intimidating a person, verbal abuse, threats, belittling or humiliating a person;
  • Yelling or using profanity or making jokes, that are offensive (written, verbal or graphic);
  • Punishment;
  • Tampering with a person’s personal belongings or work equipment; Undermining or deliberately impeding a person’s work; and
  • Other objectionable behavior designed to torment, pester or abuse someone.

Sexual harassment - A specific form of discriminatory harassment related to the prohibited grounds of sex (gender) or sexual orientation. It is not possible to identify each and every act that constitutes sexual harassment.

Sexual harassment can include:

  • Unwelcome flirtations, advances, propositions, solicitation, requests for sexual favours, lewd or suggestive comments or other vocal activity such as catcalls, whistles and kissing sounds;
  • Vulgar or sexual jokes (oral, written or graphic);
  • Continuing to express sexual interest after becoming aware that the interest is unwelcome;
  • Unwanted physical touching, blocking or impeding movements;
  • Indecent exposure; and
  • Sexual assault.

Workplace harassment – Engaging in a course of vexatious comments or conduct against a worker in a workplace that is known or ought reasonably to be known to be unwelcome.

Racism

Racism includes the belief that one’s own race is superior to another’s, discrimination based on policy and outright hatred or intolerance. Racism is shaped by the distribution of money, power and resources, which control the social determinants of health. Racism appears in many forms. All are destructive and lead to negative health effects in individuals, families and communities

*Definitions are adapted from the Royal College’s Respectful Workplace Policy and General Standards of Accreditation for Institutions with Residency, and those by the Canadian Human Rights Commission.