‘Bad Medical Students’ find a voice in democracy movement

As Thailand’s youth-led movement for political reform has expanded to encompass other grievances faced by youth, particularly in education, Thai medical students and doctors have been expressing their own frustrations over previously unspoken problems in the country’s medical education system, sparking a new ‘Medical Students for Democracy’ effort to channel demands for change.

An intense social media debate on the hidden problems of Thailand’s well-respected medical schools and training began in late November after a Facebook post by Chiang Mai University medical lecturer Manoch Chockjamsai urging medical students to voice their opinions on medical school practices.

“I want to hear the voice of ‘bad medical students’, saying what the faculty does not want to hear,” he wrote, referring to medical schools choosing to stay quiet unless some cases of abuse and poor conditions became too severe to ignore.

His post came a day after a rally in Bangkok by the ‘Bad Student’ pro-democracy group. The group, led by high school students, was joined by thousands of students and adults and proclaimed the end of the ‘dinosaur age’ in the education system, highlighting that a system which insists on obedience and submission is outdated.

Their demand for education reform has become part of the ongoing pro-democracy movement in the country.

A day after Chockjamsai’s post, the Thai Public Broadcasting Service reported that ‘#BadMedicalStudent’ was a top hashtag on Twitter with over 116,000 Tweets within a day. In the following days, the Facebook post was shared more than 4,600 times and attracted over 800 comments, mostly from medical students, medical interns and doctors.

Most medical students and doctors expressed resentment of an authoritarian work culture in medical schools and hospitals and shared their experiences of long working hours, verbal and emotional abuse, gender discrimination, and even sexual harassment and discrimination on the basis of looks.

An open forum for medical students

Chockjamsai’s post prompted an offer from the ‘Medical Students for Democracy’ group to become a regular platform for medical students to speak out. In the past, problems faced by medical students and doctors were mentioned piecemeal in individual social media posts.

“Recently, the discussion of problems and bad [work] culture in medical schools has made a comeback with the hashtag ‘#BadMedicalStudent’ on Facebook and Twitter. The ‘Medical Students for Democracy’ webpage volunteers to be a channel for every oppressed medical student who wants to express your thoughts through us,” the group wrote in a post.

A post by ‘a specialist doctor at a private hospital’ mentioned gender bias and long working hours. “During the [ward] rounds, if you can’t answer a question you will be scolded in front of the patients, not to mention 24 hours of work on a shift.” Often, she said, they worked 42 hours without sleep.

A female medical student by the name ‘saiuuiuu’ tweeted about sleep deprivation and gender bias in her medical school. “[To be] a medical student is to study hard, and to have sleep deprivation from school to work. [We are] taught to take care of [people’s] health, but I do not have enough sleep and have to go to school. My body must be exhausted, right? Sometimes I’m conflicted. Also, can’t women study to be a surgeon, or must it be men only?”

‘Tor’, a third-year medical student from a Bangkok-based public university, told University World News that social media posts under #BadMedicalStudent help explain the root cause of problems once kept under wraps throughout the medical professional training cycle.

“These are problems we [medical students] have long known about, and many of us have experienced them. The anonymity provided by social media, especially Twitter, helps us to speak up. It is hard enough trying to perform well in studies and to meet family expectations. Bullying and other problems make it even harder for us,” he said.

“I think having a chance to express ourselves freely through social media is good. At least the public will understand us more,” he said. The #BadMedicalStudent campaign has also helped individual grievances become collective, ‘Tor’ said, although he was not sure if there would be any solution provided by institutions anytime soon.

Airing frustrations

It has been rare for conditions for medical students to come to light.

In an interview with Bright TV on 24 November, Dr Kanokwan Sriraksa, from Khon Kaen Hospital, said problems such as bullying or sexual harassment existed in every institution. These may exist in medical institutions as well, but students did not have a chance to talk about it before.

“Bullying is a systemic problem which can’t be solved individually. It is good if doctors see it as problematic and help push for a change for the sake of the community and the public, not for the individual’s sake,” she said.

Previously media reports on the suicide of a medical student at Mahidol University’s Siriraj Hospital, in March 2018, caught the public’s attention after Anti-SOTUS – a network of youth groups that campaigns against human rights violations in universities – alleged the university wanted to cover it up by prohibiting posts about it.

This prompted Prasit Watanapa, dean of the faculty of medicine at Siriraj Hospital, to explain to the media that Siriraj did not intend to bury the case. Instead, he claimed that because it was a sensitive issue, publicity could affect the student’s parents.

A senior medical student who knew the deceased posted on his Facebook page after the incident in 2018, warning fellow students about mental health problems related to medical studies and suggesting they seek expert help.

“To study medicine, one has to sacrifice many things, mainly your basic needs such as eating, sleeping, time and personal life,” he wrote. If students cannot adapt to the system, “they could become depressed, stressed or sad to the point they do not want to live.”