Violence and Aggression Towards Medical Students: A Systematic Review of Prevalence, Impact and Interventions

BACKGROUND: Violence and aggression in healthcare is a growing concern. Whilst the experiences of healthcare workers are well understood, less is known about the impact on medical students. Often among the most junior members of clinical teams, they may be particularly vulnerable facing unique academic and career-related consequences. We explored the prevalence, impact of and interventions for violence towards medical students. METHODS: A comprehensive literature search was conducted. Studies were eligible if they involved medical students exposed to violence or aggression from patients or their families and reported on prevalence, impact or interventions. Screening, data extraction and quality assessments were completed independently by two reviewers in line with PRISMA guidance. A narrative synthesis was used to describe results. FINDINGS: Fifteen studies were included. Published between 2005 and 2024, studies spanned 10 countries and included sample sizes from 24 to 4505 students. Reported prevalence ranged from 12% to 68%. Impacts were psychological including suicidal ideation, depressive and anxiety symptoms alongside other health-related issues, namely, sleep disturbance and alcohol misuse. Academic and career-related implications were identified. Studies reported very low rates of incident reporting, citing fear of consequences and limited awareness of reporting processes. Evaluated interventions were exclusively educational and findings relied heavily on self-reported data. Implications Medical students experience violence at a concerning rate, with wide-ranging consequences. Underreporting is significant and existing interventions are limited in scope. There is a clear need for institutional policy development and further research to better protect medical students and support their professional development.