Bullying, undermining behavior, and harassment during general surgery training in Belgium: a national cross-sectional survey

Background Bullying, undermining behavior, and harassment (BUBH) persist as ongoing concerns in healthcare, particularly within stressful environments. This study aims to explore the prevalence and characteristics of BUBH among Belgian general surgery residents.Methods A cross-sectional survey was distributed online using an anonymous link through newsletters and social media channels of the Belgian Association of Surgical Trainees. The survey comprised 54 questions including: A) demographic; B) instances of BUBH, adapted from the validated Leymann Inventory of Psychological Terror and the Negative Acts Questionnaire; C) reporting, perpetrators, and management of BUBH derived from the survey developed by Rouleaux Club (United Kingdom).Results Fifty-six surgical residents, aged 24 to 40 years, participated. Of them, 18 (32%) were junior, 26 (56%) senior, and seven (12%) were enrolled in a research trajectory. Most respondents were Caucasian (82%), female (61%), heterosexual (93%), and without disability (98%). BUBH was experienced by 38 (68%) residents, while 44 (79%) witnessed BUBH towards their colleagues. Main perpetrators were consultants (n = 40/132; 30%) and nursing staff (n = 28/132; 21%). Reported behaviors included an unmanageable workload (n = 53; 95%), ignored opinions, (n = 52; 93%) and working below competence (n = 51; 91%). BUBH primarily occurred in operating rooms (39%), hospital wards (34%), or emergency rooms (11%).Conclusion This is the first national study examining BUBH during surgical training in Belgium. Results highlight how BUBH is often misidentified and underreported. Proactive measures, educational programs, and support networks are essential to effectively address and mitigate these issues.