Years ago, when I was a medical student trying my hand at a variety of specialties, I spent two months on the surgery service. The days were rigorous, starting before 5 a.m., when I was expected at the hospital to round on patients who had recently undergone surgery. I then scrubbed in to the first operating room case of the day, at 7 a.m. Depending on the complexity of the procedure, we wouldn’t emerge from the O.R. for hours, biologic needs such as going to the bathroom or eating be damned. Another case, more rounding, and I typically surfaced from the hospital at dusk, completely exhausted.

Unless I dared to inquire when we would be done with rounds.

“Whenever you ask me ‘When will we round out?’” the surgical fellow told me and the other medical students, more than once, “I will make it one hour later.” This was said unsmilingly, and he delivered on his promise.

Our supervisor’s behavior was a form of bullying, and not the last time in my career that I would face it.

Bullying involves an imbalance of power between the perpetrator and the victim: in our case, between a fellow or staff physician and a resident or medical student. It occurs repeatedly over time. A victim’s inability to defend him- or herself is also part of the equation — we feared any grade less than high honors, which could compromise the type or quality of residency we might obtain, and would be determined largely by the fellow. Finally, the intention of bullying is to cause harm or distress — our fellow seemed to delight in our fear.