A surgical habitus: surgeons' perspectives on learner mistreatment in surgery

Learner mistreatment remains a pervasive challenge in medical education, particularly within the surgical learning environment. In medical education scholarship, surgical culture is often cited both as an explanation, and at times, a justification for learner mistreatment in surgery. In this critical qualitative study, informed by constructivist grounded theory, we conducted 20 interviews with surgical faculty, representing 10 different surgical disciplines at a Canadian institution. Surgeons were invited to reflect on their encounters with mistreatment throughout their medical careers. While many surgeons recounted instances of mistreatment during their own training, few recalled witnessing learner mistreatment in their current roles as surgical faculty. This paper utilizes Pierre Bourdieu's concept of habitus as an analytical tool to enhance our understanding of surgeons' perspectives and move beyond reductionist explanations that regard mistreatment as an inherent aspect of surgical culture. Through an exploration of how aspects of surgical culture are embodied and reproduced through the cultivation of a surgical habitus, we provide insights into why learner mistreatment persists in surgery.