Pink Shirt Day: Taking a stand against bullying today and every day

On Pink Shirt Day, I will proudly wear pink to stand in solidarity with this grassroots initiative that aims to raise awareness about bullying and create a more inclusive world – one where bullying has no place and where bystanders become upstanders. And I challenge all of us in medicine to rise to the occasion, to wear pink on February 23 but to also commit to taking a stand against bullying every day, not just the third Wednesday in February.

Bullying can show up in many ways. It can come in forms of aggression, threats, intimidation, and harassment. It is not confined to the playground or school, and it is not limited to children and youth. It permeates and pervades many systems and is experienced well into adulthood. It shows up in our medical education, medical training, the cyberspace, our workplace, and our personal lives. Anywhere there is a power imbalance, or within conservative traditional hierarchical structures, we are at risk.

In fact, more than 75% of people say they’ve been bullied. More than 90% of bullying incidents have peer witnesses and when those peers intervene, most incidents are over within seconds. But if they don’t – if these witnesses act as bystanders and not upstanders – the ongoing bullying can have dire and long lasting consequences. It is linked to adverse mental health ramifications and can persistently challenge our physical health, along with our psychological safety and well-being.

How many of us in medicine experience or tolerate it? The Canadian Medical Association Journal reports that 75% of medical students and residents disclose bullying, and it is a silent epidemic according to Field, et. al. of the British Medical Journal. The magnitude to which it permeates our systems is jarring. However, it can only continue if the conditions and its constituents allow it. If we want to foster a culture in medicine that promotes health, we need to scrutinize our structures and clinical environments. We must not condone this behaviour, but rather confront it. Bullying in medicine has perpetuated a culture of intimidation, shame, harassment, and an inability to speak up out of fear of reprisals or retaliation. But how many of us don’t speak up against an intimidation or threat when we see it, or permit the abuse of a power dynamic?

Pink Shirt Day began here in Canada, 15 years ago, when two students took a stand against homophobic bullying after a new Grade 9 student was harassed and threatened for wearing pink. These young students followed their moral compass and set a precedent, because they understood that acting as mere spectators, meant they were part of the problem. The days of bystander participation in the exploitation or amplification of bullying, threats, intimidation or harassment need to end now. A bystander can influence a situation by becoming an upstander – someone who witnesses what happens and intervenes or speaks up to stop the bullying. Our voices matter, and using them to speak the truth and to speak up is crucial.

Yesterday we may not have had the courage or volume of our collective voices, but today it is different. Today we will no longer cower to the bullies in the system, in the office, the hospital, our public places, or private spaces. If we are to commit to the evolution of healthcare and its delivery, allow us to confront the toxicity embedded in the culture. No more silence on issues that matter. No more acceptance of what is intolerable. The time has come to call out the behaviour we will no longer accept, to create a culture in which our future generations can applaud our commitments and operate with dignity, respect, and psychological safety. Bullying, intimidation, and harassment have no place in our workplace or in medicine. Not now, not ever.

So this Pink Shirt Day and every day, I challenge you to speak up for yourself and others. This is how we will change what is accepted in our work places, our communities, and in society. Our future generations task us with the leadership we need to aspire to today.

- Dr Ramneek Dosanjh