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Article

Interns’ Abuse Across the Healthcare Specialties in Saudi Arabian Hospitals and Its Effects on Their Mental Health

by
Farah A. Alghamdi
1,
Bushra M. Alghamdi
2,*,
Atheer A. Alghamdi
2,
Miad A. Alzahrani
2,
Basmah Ahmed Qasem
3,
Atheel Ali Alshehri
4,
Alwaleed K. Aloufi
5,
Mohammed H. Hakami
6,
Rawaa Ismail Mohammed Ismail
7,
Alaa H. Hakami
8,
Ahmed Elabwabi Abdelwahab
9 and
Sultan Mishref Alghmdi
10
1
College of Medicine and Surgery, King Faisal University, P.O. Box 400, AL Hofuf 31982, Saudi Arabia
2
Faculty of Medicine, Al-Baha University, P.O. Box 1988, Al Baha 65431, Saudi Arabia
3
Independent Researcher, Makkah 24224, Saudi Arabia
4
College of Medicine, King Khalid University, P.O. Box 960, Abha 61421, Saudi Arabia
5
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 9515, Jeddah 21423, Saudi Arabia
6
Faculty of Medicine, Jazan University, P.O. Box 2097, Jazan 45142, Saudi Arabia
7
Eradah Complex and Mental Health Hospital, Riyadh First Health Cluster, Alkharj 16439, Saudi Arabia
8
Department of Psychiatry, Prince Sultan Military Medical City, P.O. Box 12233, Riyadh 12233, Saudi Arabia
9
Department of Psychiatry, Faculty of Medicine, Al-Baha University, P.O. Box 1988, Al Baha 65431, Saudi Arabia
10
Department of Psychiatry, King Fahad Hospital, Ministry of Health, P.O. Box 7838, Riyadh 11461, Saudi Arabia
*
Author to whom correspondence should be addressed.
Psychiatry Int. 2025, 6(3), 89; https://doi.org/10.3390/psychiatryint6030089
Submission received: 14 February 2025 / Revised: 20 June 2025 / Accepted: 14 July 2025 / Published: 24 July 2025
Browse Figures
Versions Notes

Abstract

Healthcare abuse is a critical human rights and public health issue, particularly impacting medical interns and trainees who are vulnerable to mistreatment during their formative professional years. This cross-sectional study, conducted from February to June 2024, evaluated the prevalence and psychological impact of harassment and discrimination among 463 healthcare interns in Saudi Arabia from various specialties, including medicine, nursing, pharmacy, and dentistry. Using a self-administered online questionnaire, we found that mistreatment was widely reported, with female interns experiencing significantly higher rates of sexual harassment and gender-based discrimination. Common perpetrators included residents, lecturers, professors, nurses, and patients, with incidents most frequently occurring in surgical and internal medicine departments. Despite high prevalence, only 9% of interns reported the abuse due to mistrust in reporting systems or failure to recognize the behavior as abuse. These experiences were associated with significant psychological distress, including frustration, reduced motivation to learn, and higher DASS scores, particularly among female interns. The study underscores the need for institutional reforms, including policy development, cultural change, and effective reporting systems to ensure a safe and supportive learning environment for future healthcare professionals. Addressing abuse in medical training is essential for individual well-being and the sustainability and integrity of healthcare systems.

1. Introduction

Workplace abuse in healthcare is a complex and ongoing issue involving social, ethical, medical, and psychological dimensions [1]. It includes behaviors that violate human and civil rights, leading to physical, sexual, emotional, or financial harm [2]. In healthcare settings, abuse often takes the form of incivility, discrimination, harassment, bullying, physical aggression, and abusive leadership, sometimes sustained by institutional cultures that tolerate such behavior [3].
Medical interns and undergraduate trainees are particularly vulnerable to workplace abuse due to their limited clinical experience and dependence on senior staff. This exposure has been associated with adverse psychological outcomes such as depression, anxiety, post-traumatic stress disorder (PTSD), and other stress-related conditions [4]. Key factors contributing to this vulnerability include insufficient knowledge, lack of autonomy, and limited practical skills, especially among nursing interns [5,6].
A systematic review and meta-analysis found that 61.9% of healthcare workers globally experience workplace violence (WPV), with 42.5% subjected to non-physical abuse and 24.4% to physical aggression [7]. In Saudi Arabia, workplace mistreatment during healthcare training is a significant concern. Studies indicate that 39.4% of nursing interns have experienced verbal abuse, primarily from patients and staff members [8]. At King Abdul-Aziz University, 90.9% of medical students reported abuse during training, with professors identified as the main perpetrators [9]. Moreover, 70% of medical residents have reported bullying, mostly by consultants and specialists, with junior trainees being disproportionately affected [10,11].
The psychological impact on trainees is considerable. For example, 53.8% of male medical students and interns at Al-Baha University reported symptoms of depression, with 4.4% experiencing severe or major depression. Although no demographic factors were significantly linked to depression, students with a history of domestic abuse or violence were more likely to suffer from severe depression, suggesting a strong connection between past abuse and current mental health challenges [12].
Despite increasing attention to the issue, there remains a lack of research focusing on the prevalence and psychological consequences of workplace abuse among interns in Saudi Arabia. This study aims to assess the extent of mistreatment, explore interns’ perceptions, and evaluate its psychological effects. Addressing this gap can support the development of policies and interventions to foster a safer, more supportive training environment.

2. Materials and Methods

2.1. Study Design and Sample Size

Inclusion criteria:
  • Interns of the healthcare specialties (medical, dental, nursing, and pharmacy);
  • Agree to participate;
  • Both females and males;
  • Residing in Saudi Arabia.
Exclusion criteria:
  • Incomplete questionnaires will be excluded;
  • Participants who refused to participate would be ineligible.
A cross-sectional study was conducted between February 2024 and June 2024 to provide comprehensive insight into the prevalence of abuse and its effect on mental health among interns in healthcare specialties in Saudi Arabia. According to the Raosoft website, the estimated sample size was 385, with a 95% confidence level, a 5% margin of error, and a 100% response rate.

2.2. Sampling Method

The study employed a convenient sampling technique. The data was collected through a self-administered online questionnaire, which was distributed to the participants via various social media platforms, including WhatsApp, X, Telegram, and others.

2.3. Data Collection and Management

Data was collected using two questionnaires. The first questionnaire was a detailed instrument, validated and previously used in similar studies [13,14]. Therefore, no specific validation process was conducted in the current study. However, a pilot study was conducted through an online survey that included 20 participants to ensure clarity, suitable formatting, structure length, and flow. Technical issues, navigation, and suggestions were also considered. Two experts performed a content validation assessment, and the content validation index was calculated, which was found to be 0.84. The questionnaire consisted of sections on personal data, the type of abuse experienced, and the faculty member involved.
The first questionnaire had three main sections:
  • The first section focused on sociodemographic information, including age, gender, major, and college.
  • The second section assessed the frequency with which participants perceived themselves to have experienced abuse, the source of abuse, and the type of abuse (verbal abuse, physical assault, academic aggression, sexual abuse, and gender discrimination). Each item categorizes abuse into distinct domains to allow for granular analysis.
  • The third section explored whether students reported mistreatment, assessed the frequency of reporting experienced abuse, the reasons for non-reporting of perceived abuse (investigated barriers to reporting abuse, including the following: lack of awareness or recognition of abuse, fear of consequences (e.g., grades, professional retaliation), distrust in confidentiality or fairness of reporting processes, belief that reporting is ineffective or burdensome, and personal coping strategies like avoidance or self-resolution), and the participants’ reactions to the abuse.
The second questionnaire involved the measurement of depression, anxiety, and tension/stress using the DASS score, which is a validated psychometric tool to assess mental health outcomes, scored on a 4-point Likert scale ranging from 0 (not at all) to 3 (most of the time) that offers quantitative insight into the psychological impact of mistreatment [15].

2.4. Data Analysis

The data analysis was performed using the Statistical Software for Social Sciences (SPSS) version 29. Categorical variables were described using frequencies and percentages, while descriptive statistics such as mean and standard deviation (SD) were used to summarize the scale variables. The Chi-square test, Mann–Whitney test, and t-test were employed, with a significance level of p < 0.05 considered statistically significant. A confidence level of 95% was used with a margin of error of 5%.

2.5. Ethical Approval

The study received approval to be conducted from the Scientific Research and Ethics Committee (REC) at Al-Baha University (reference number REC/SEC/BU-FM/2024/13, dated 24 January 2024).

3. Results

This study investigated the demographics of interns and the prevalence of harassment and discrimination they experienced during internship training in Saudi Arabia.

3.1. Intern Demographics

A total of 463 interns participated in the survey and met our criteria. The majority (67.8%) were female, with a smaller proportion (32.2%) being male. All interns were between the ages of 20 and 30 years old. Regarding internship province, most interns came from the Eastern province (32.6%), followed by Riyadh (22%). Medicine was the most common major (60.7%), followed by pharmacy (14.9%) (Table 1).

3.2. Prevalence and Types of Harassment and Discrimination

The study found that many interns experienced harassment and discrimination during their training. There were no significant variations between males and females in experiencing verbal aggression, physical assault, or academic aggression. However, females reported significantly higher rates of sexual harassment and gender discrimination compared to males. Regarding sexual harassment, most of the females (ranging from 76.5% to 80.5%) reported experiencing various forms of sexual harassment, including unwanted comments, attention, advances, and physical contact. Regarding gender discrimination, a considerable portion of females (ranging from 64.3% to 79.3%) reported facing gender discrimination, such as being denied opportunities or having restrictions placed on their career choices (Table 2).

3.3. Perpetrators and Departments of Harassment and Discrimination

Interns reported harassment and discrimination from various sources, residents or house staff being the most common perpetrators (176 responses). Other reported perpetrators included lecturers, professors, nurses, and even patients (Figure 1).
Surgery and Internal Medicine departments were the most frequent settings for mistreatment (133 and 92 responses, respectively) (Figure 2).

3.4. Attitude Towards Different Types of Harassment

Only a small percentage (9%) of participants reported their harassment experiences to someone in authority. The most common reasons for not reporting were doubting the effectiveness of reporting (28.7%), followed by believing the experience was not significant enough (21.2%) and not recognizing the experience as abuse (17.5%). Harassment experiences led to a range of adverse emotional reactions, including anger (27.4%), decreased eagerness to learn (25.7%), feeling uncomfortable and nervous (25.5%), depression (16.2%), and fear (14%). Interestingly, a significant portion (28.3%) reported feeling more eager to learn after experiencing mistreatment (Table 3).

3.5. Mental Health (DASS) of the Interns

3.5.1. Mental Health Differences Between Male and Female Interns

On applying the student t-test, females reported significantly higher mean scores on the Depression, Anxiety, and Stress Scale (DASS) compared to males, p value > 0.05 (Table 4).

3.5.2. Gender Differences in Specific Aggressive Behaviors

On comparing mental health (DASS) among the interns regarding different types of harassment, we found no significant mental health difference between interns who reported the harassment and those who did not report it. In contrast, there is a significant difference in depression, anxiety, and stress scale between those who experienced verbal aggression, physical assault, academic aggression, sexual assault, and gender discrimination, p value = 0.001 (Table 4).

4. Discussion

Bullying and harassment of interns by those higher in the medical hierarchy in the health care system can adversely affect the medical educational process and experience. These experiences may lead to long-term psychological effects and affect their mental health. The literature of the last decade showed that the prevalence and impact of bullying or harassment are well-known and established [13,14,15,16]. However, comparing studies from different cultures and sociodemographic and research methodologies is difficult, as are the definitions of intern abuse or harassment. Baldwin et al. [17] used the words “mistreatment” and “harassment,” replacing the term “bullying” that Ahmed et al. and Alzahrani et al. [18,19] used. While bullying includes threats to one’s personal and professional standing, isolation, overwork, and destabilization, abuse and perceived mistreatment are comparatively broader words that also include sexual harassment.
Previous studies have found that verbal abuse was the most reported form of abuse among interns [16,20,21,22]. Our study showed verbal aggression was the most common type, after academic aggression, representing 52.7%, similar to Shdaifat et al. [23], who found that about half of the participants had been exposed to at least one type of verbal aggression once a year. However, Iftikhar et al. [9] found that 86.6% of all reported forms of abuse by the interns at the King Abdul Aziz University are verbal aggression, which is comparable to the 90% reported in another Saudi study [19]. In contrast, in a study conducted in Jordan [18] among nurses, they reported only 37% of verbal abuse in their training.
The widespread trend of verbal abuse suggests that spoken communication is a common way to harm or misunderstand others. This highlights the need for physicians to be trained to communicate critical comments responsibly without being patronizing or threatening.
Academic abuse during intern training in hospitals can have significant negative mental and psychological consequences. It often involves the abuse of authority by senior medical staff, which can impede the education or career progression of interns through giving assignments as punishment, threatening to get a bad grade without justification, unjustifiably threatening to fail a class or during clinical training, facing malicious or unfair competition, and making negative statements about becoming a health professional or continuing in the health field. A total of 53.6% of our interns encountered academic abuse in their training. In comparison, 73% of another Saudi study [9] reported instances of academic abuse, and 61% documented alleged academic abuse in National Guard Hospitals in Riyadh, Jeddah, and Al-Ahsa’a [24].
The effects of such abuse can lead to psychological distress among interns, with a systematic review reporting that 39.1% of respondents experienced this impact [25].
Sexual harassment during medical training is a serious issue that affects many interns. Sexual harassment ranges from unwanted attention and invitations to physical advances, sexual comments, and sexual bribery. The prevalence of perceived sexual harassment in our study ranged from 8.2% to 29%, according to the type of sexual assault. Iftikhar et al. [9] showed that 8.6% had been exposed to sexual abuse, which is higher than the 6% reported by Alzahrani [19]. Whereas 41%, which is a very high rate reported among interns at National Guard Hospitals in Riyadh, Jeddah, and Al-Ahsa’a [24], when compared with data from developed countries, the prevalence of perceived sexual harassment in our population is less than that reported among medical interns [20]. A total of 42.5% of interns recorded a type of sexual harassment in Japan [26], as emphasized by Al-Shafaee et al. Recent studies have shown that the prevalence of sexual harassment among medical interns remains a significant concern. For instance, a study published in the JAMA Health Forum in 2024 reported that the incidence of sexual harassment among interns decreased from 62.8% in 2017 to 54.6% in 2023 [27], indicating a problem despite a mild improvement. Another study highlighted that nearly two-thirds of interns experienced sexual harassment, with a higher prevalence among women (77.2%) compared to men (50.9%) [28].
Our results showed females are more susceptible to sexual assault than males; unwanted attention, unwelcome verbal advances, personal invitations, offensive body language, and physical advances were similar to Kobayashi et al. [26], who reported that females have a significant prevalence of different sexual harassment.
Gender discrimination in our study ranged from 15% in refusal to attend a conference to 47% in assessment according to gender. Also, females faced more restrictions in career choice than males. Kobayashi et al. [26] found gender discrimination ranged from 2% to 15% without any significant difference between males and females. In comparison, Fnais et al. [24] reported gender discrimination ranged between 16% and 58% according to the assault.
We found that respondents cited their residents, followed by patients, as the perpetrators of perceived abuse in most cases. In a study conducted at King Abdul Aziz University, they were exposed to harassment mostly by their professors; this is consistent with research conducted in the East and the West [18]. Abuse might occur because of the mentor’s authority and position over the interns.
The surgery department was the most frequently cited (28.7%) department where the interns were exposed to abuse, followed by the internal medicine department (19.8%). This aligns with another study [29] conducted in Saudi Arabia that showed similar results. The demanding workloads in these departments may increase conflicts between the interns and staff members. Several previous studies have also linked the hierarchical nature of surgical departments to increased harassment and abuse [17,20,30,31].
Our study found significant underreporting of mistreatment experiences; 91% of that is due to different reasons like not thinking reporting would accomplish anything, not knowing to whom they should report, or fear of not being believed. That was comparable to the results of interns at King Abdul Aziz University [9], who found that 85% of them did not report mistreatment or harassment.
Underreporting is an aspect of medical interns’ perception of abuse that cannot be ignored, as evidenced by our data, which also suggests that interns’ mistrust of the system—including their fear of facing consequences for reporting—led to underreporting of perceived abuse; additionally, the lack of an official system for reporting abuse and interns’ fears of reporting a mentor in an authoritative position favor underreporting; additionally, in addition to the psychological effects of abuse, some interns refrained from reporting because they believed they would be reliving the pain if they did so.
On studying the mental effects of harassment on the interns and estimating DASS, we found that females are more liable to depression, anxiety, and stress than males, resulting from abuse. The higher DASS scores among female interns in our study are consistent with previous research indicating that female medical professionals are at a greater risk for depression and anxiety. For instance, a study published in the Annals of Internal Medicine found that the increase in depression scores for the first post-medical school year was more pronounced among female interns [32]. This could be an indicator of the broader societal pressures and gender-based disparities that women face in hospitals.
Our study did not find a significant difference in overall mental health between interns who reported harassment and those who did not. This contrasts with the findings from a study reported by the previous study, which acknowledged a significantly higher number of interns developing major depressive episodes and experiencing burnout due to various stressors, including harassment. However, our study did find a significant association between verbal aggression and increased anxiety, which is in line with the literature that suggests verbal harassment can lead to distress and mental health issues.
The significant impact of academic aggression on depression and anxiety in our study adds to the body of evidence that academic pressures and related harassment are detrimental to mental health. The significant mental health impact of sexual assault and gender discrimination found in our study echoes the concerns raised in other research. Also, Cornejo et al. [33] reported that maltreatment in internships and depression are related. This would signify potentially unfavorable working conditions for the medical intern, pointing to an institutional culture emphasizing authority abuse.
These experiences can profoundly affect interns’ mental health, performance, and career progression. Medical institutions must address this issue by implementing robust policies and support systems to protect interns and encourage reporting such incidents without fear of retaliation.
While the study did not find significant associations between physical or sexual assault and psychological distress or anxiety, this lack of association could be attributed to underreporting, normalization of certain behaviors, or cultural attitudes that discourage emotional expression among medical interns. In contrast, the significant link between academic assault and depression/anxiety may suggest that interns more directly internalize academic-related pressures. The intense focus on academic performance might lead them to neglect other aspects of their well-being, potentially compounding emotional distress over time. This interpretation aligns with previous findings highlighting the mental health burden of academic environments in medical training.

5. Conclusions

Determination of the most common types of harassment and abuse is the first step to clarifying the problem. The culture within medical training that promotes resilience and deference can create barriers to addressing mistreatment. Structural changes are needed to combat injustice and harassment to ensure the well-being of future doctors and the quality of patient care. It is important for medical institutions to develop policies and establish a formal reporting system that protects interns from abuse and to build an environment where they can report such incidents without fear of retribution.
Addressing this issue requires first acknowledging the existence of harassment and discrimination among medical interns and identifying the most common forms of mistreatment. We recommend developing comprehensive strategies to eliminate such behaviors within the medical community. Specifically, we recommend that program administrators and policymakers take more decisive action when handling harassment and discrimination during internship training. While some conflict resolution policies exist, we recommend enhancing training programs by introducing more precise definitions and targeted interventions to correctly identify and eliminate the various forms of abuse that occur.
The strong points of our study are the large sample size, different and detailed types of abuse, primarily academic and sexual, and the mental health state evaluation of the interns through DASS. It is the first study, to our knowledge, that assessed the association of depression, anxiety, and stress and their relation to the different patterns of types of assaults and harassment. However, some limitations should be considered. First, a cross-sectional design was applied in this study, and causal relationships between variables could not be estimated. Second, recall bias may have affected their ability to respond accurately to the questionnaire. Third, the survey was distributed online, so there may have been a selection bias. These limitations limit the generalizability of the present findings.

Author Contributions

Conceptualization, F.A.A. and S.M.A.; methodology B.A.Q.; software B.M.A.; validation, F.A.A., A.A.A. (Atheel Ali Alshehri) and M.A.A.; formal analysis, B.M.A.; investigation, B.A.Q., A.A.A. (Atheer A. Alghamdi) and R.I.M.I.; resources, A.A.A. (Atheel Ali Alshehri); data curation, B.M.A.; writing—original draft preparation, A.A.A. (Atheer A. Alghamdi), M.H.H., R.I.M.I. and B.M.A.; writing—review and editing, A.A.A. (Atheel Ali Alshehri), M.A.A., A.K.A. and M.H.H.; visualization A.A.A. (Atheel Ali Alshehri) and M.A.A.; supervision, S.M.A. and A.E.A.; project administration, B.M.A.; funding acquisition, A.H.H. and S.M.A. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Scientific Research & Ethics Committee (REC), Faculty of Medicine, Al Baha University (Approval Code: REC/SEC/BU-FM/2024/13; Approval date: 24 January 2024).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The original contributions presented in this study are included in the article. Further inquiries can be directed to the corresponding author.

Conflicts of Interest

The authors declare no conflict of interest.

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Psychiatryint 06 00089 g001
Figure 1. Prevalence of the perpetrator(s) during clinical training (responses = 662).
Figure 1. Prevalence of the perpetrator(s) during clinical training (responses = 662).
Psychiatryint 06 00089 g001
Psychiatryint 06 00089 g002
Figure 2. Prevalence of the experienced mistreatment: in which department(s) did it occur? (Responses = 451).
Figure 2. Prevalence of the experienced mistreatment: in which department(s) did it occur? (Responses = 451).
Psychiatryint 06 00089 g002
Table 1. Interns’ demographics.
Table 1. Interns’ demographics.
SociodemographicN (%)
GenderMale
Female		149 (32.2)
314 (67.8)
Age (years)20–30463 (100)
Internship provinceRiyadh
Eastern
Aseer
Mekkah
Al-Baha
Al-Qassim
Others		102 (22)
151 (32.6)
52 (11.2)
49 (10.5)
16 (3.5)
10 (2.2)
83 (18)
MajorMedicine
Pharmacy
Dentistry
Nursing
Other		281 (60.7)
69 (14.9)
53 (11.5)
55 (11.9)
5 (1)
Table 2. Prevalence and types of intern harassment and discrimination during internship training.
Table 2. Prevalence and types of intern harassment and discrimination during internship training.
VariableMale N (%)Female N (%)Total (%)p Value
Verbal aggression77 (31.6)167 (68.4)244 (52.7)0.8
Physical assault16 (29.1)39 (70.9)55 (11.9)0.6
Academic aggression
(e.g., giving assignments as punishment, threatening to get a bad grade without justification, unjustifiably threatening to fail a class or during clinical training, facing malicious or unfair competition, and making negative statements about becoming a health professional or continuing in the health field)		72 (29)176 (71)248 (53.6)0.1
Sexual Assault
Sexual comments16 (23.5)52 (76.5)68 (14.7)0.09
Unwanted attention28 (20.9)106 (79.1)134 (29)0.001 *
Unwelcome verbal advances (e.g., expressions of sexual interest or sexual inquiries)24 (22.6)82 (77.4)106 (23)0.02 *
Unwanted, persistent personal invitations17 (20.7)65 (79.3)82 (17.7)0.014 *
Unwelcome explicit proposition18 (23.4)59 (76.6)77 (16.6)0.07
Offensive material display (e.g., display of offensive sexual pictures or cartoons)9 (22.5)31 (77.5)40 (8.6)0.2
Offensive body language (e.g., repeated leering; standing too close)27 (19.1)114 (80.9)141 (30.4)0.001 *
Unwanted physical advances17 (20.7)65 (79.3)82 (17.7)0.01 *
Sexual bribery (e.g., offers of better grades, other advantages, or threats in exchange for sexual favors)8 (21.1)30 (78.9)38 (8.2)0.1
Gender Discrimination
Denied or restricted the opportunity to examine patients55 (35.7)99 (64.3)154 (33.3)0.3
Denied the opportunity to participate in a medical technique44 (32.1)93 (67.9)137 (29.6)0.9
Assignments made based on gender70 (31.7)151 (68.3)221 (47.7)0.8
Denied attending a conference or meeting23 (31.9)49 (68.1)72 (15.5)0.9
Restriction of career choice28 (20.7)107 (79.3)135 (29.2)0.001 *
* p value is significantly less than 0.05.
Table 3. The attitude of interns towards different types of harassment.
Table 3. The attitude of interns towards different types of harassment.
VariableN (%)
  Did not recognize the experience as abuse at the time.81 (8.9)
- Considered the experience abusive but judged it not significant enough to report.98 (10.7)
- Did not think reporting would accomplish anything.133 (14.5)
- Considered reporting more troublesome than it was worth.40 (4.4)
- Dealt with the problem directly.45 (5)
- Did not know to whom to report.63 (6.9)
- Fearful reporting would adversely affect evaluation.16 (1.7)
- The mistreatment stopped.28 (3)
- Fearful reporting would not be kept confidential.51 (5.6)
- Did not think the problem would be dealt with fairly.19 (2)
- Did not want to be labeled.21 (2.3)
- Fearful of not being believed.63 (7)
- Concerned about being blamed.15 (1.6)
- Did not want to think about the mistreatment further.13 (1.4)
- Fearful reporting would negatively influence a professional career.45 (4.9)
- Despaired of the current learning situation during the apprenticeship.24 (2.6)
- None of the above.160 (17.5)
If you experienced mistreatment, what was your reaction to this? mistreatment? (Select one or more) (responses = 791).Anger127 (19)
Little impact48 (6)
Dismissal of the mistreatment experiences45 (5.7)
Diminished eagerness to learn119 (15)
Uncomfortable, nervous118 (15)
Depressed75 (9.5)
Afraid65 (8.2)
More eager to learn131 (16.5)
Insomnia, loss of appetite33 (4.2)
Thought about dropping out30 (3.7)
Table 4. Difference in mental health (DASS) between different types of assaults and harassment among interns.
Table 4. Difference in mental health (DASS) between different types of assaults and harassment among interns.
VariableDepression Mean ± SDAnxiety Mean ± SDStress Mean ± SD
Gender
Males8.47 ± 106.5 ± 98.4 ± 10
Females14.8 ± 11.612.4 ± 1115.3 ± 11.3
p value0.02 *0.001 *0.01 *
Reporting the abuse to the authority
Yes12.6 ± 11.712.5 ± 12.714.2 ± 11.2
No12.8 ± 11.510.3 ± 10.613 ± 11.4
p value0.90.20.4
Verbal aggression
Yes15.9 ± 11.613.6 ± 11.316.2 ± 11.3
No9.3 ± 10.47 ± 99.5 ± 10.3
p value0.001 *0.001 *0.001 *
Physical assault
Yes18.4 ± 10.618.4 ± 10.618.2 ± 9.6
No12 ± 11.59.4 ± 10.412.4 ± 11.4
p value0.001 *0.001 *0.001 *
Academic aggression
Yes16 ± 11.813.8 ± 11.316.3 ± 11.3
No9 ± 106.7 ± 8.79.3 ± 10.2
p value0.03 *0.001 *0.001 *
Sexual assault
Yes10.6 ± 11.87.7 ± 1010.7 ± 11.5
No15.4 ± 10.613.7 ± 1115.8 ± 10.6
p value0.001 *0.001 *0.001 *
Gender discrimination
Yes9.16 ± 116.9 ± 9.99.5 ± 11.2
No15.3 ± 11.213 ± 10.715.5 ± 10.8
p value0.001 *0.001 *0.001 *
* p value is significantly less than 0.05.
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MDPI and ACS Style

Alghamdi, F.A.; Alghamdi, B.M.; Alghamdi, A.A.; Alzahrani, M.A.; Qasem, B.A.; Alshehri, A.A.; Aloufi, A.K.; Hakami, M.H.; Ismail, R.I.M.; Hakami, A.H.; et al. Interns’ Abuse Across the Healthcare Specialties in Saudi Arabian Hospitals and Its Effects on Their Mental Health. Psychiatry Int. 2025, 6, 89. https://doi.org/10.3390/psychiatryint6030089

AMA Style

Alghamdi FA, Alghamdi BM, Alghamdi AA, Alzahrani MA, Qasem BA, Alshehri AA, Aloufi AK, Hakami MH, Ismail RIM, Hakami AH, et al. Interns’ Abuse Across the Healthcare Specialties in Saudi Arabian Hospitals and Its Effects on Their Mental Health. Psychiatry International. 2025; 6(3):89. https://doi.org/10.3390/psychiatryint6030089

Chicago/Turabian Style

Alghamdi, Farah A., Bushra M. Alghamdi, Atheer A. Alghamdi, Miad A. Alzahrani, Basmah Ahmed Qasem, Atheel Ali Alshehri, Alwaleed K. Aloufi, Mohammed H. Hakami, Rawaa Ismail Mohammed Ismail, Alaa H. Hakami, and et al. 2025. "Interns’ Abuse Across the Healthcare Specialties in Saudi Arabian Hospitals and Its Effects on Their Mental Health" Psychiatry International 6, no. 3: 89. https://doi.org/10.3390/psychiatryint6030089

APA Style

Alghamdi, F. A., Alghamdi, B. M., Alghamdi, A. A., Alzahrani, M. A., Qasem, B. A., Alshehri, A. A., Aloufi, A. K., Hakami, M. H., Ismail, R. I. M., Hakami, A. H., Abdelwahab, A. E., & Alghmdi, S. M. (2025). Interns’ Abuse Across the Healthcare Specialties in Saudi Arabian Hospitals and Its Effects on Their Mental Health. Psychiatry International, 6(3), 89. https://doi.org/10.3390/psychiatryint6030089

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