Development and Psychometric Validation of the Mistreatment Questionnaire for Medical Trainees (MQMT) in Mexican Medical Students, Interns, and Residents

Introduction: Mistreatment in medical training is a highly prevalent phenomenon that occurs in different types and forms. However, despite its high frequency, no measurement instrument has been validated that represents these different types of mistreatment in its factorial structure. Therefore, the objective of this study was to design the Mistreatment Questionnaire for Medical Trainees (MQMT) and to obtain initial evidence of its validity and reliability. Methods: Medical trainees at different stages (non-clinical and clinical undergraduate medical students, interns, and residents) were invited to participate through social media and personal invitation. The electronic survey included a 28-item pool adapted from previous mistreatment questionnaires, together with measures of anxiety (GAD-7), depression (PHQ-9), and perceived stress (PSS-10). The sample was randomly split into exploratory and confirmatory subsamples. Results: A total of 555 medical trainees were included (64% women; mean age, 23.7 years). Exploratory factor analysis (EFA; n = 280) suggested four factors, one of which combined physical mistreatment and discrimination items. A 16-item, five-factor model (academic mistreatment, psychological mistreatment, physical mistreatment, discrimination, and sexual harassment) was specified on empirical and theoretical grounds and compared with competing models in an independent subsample (n = 275), using weighted least squares with mean- and variance-adjusted test statistics (WLSMV) on polychoric correlations as the primary estimator and robust maximum likelihood (MLR) as a sensitivity analysis. The five-factor model showed good fit (CFI = 0.984, TLI = 0.980, RMSEA = 0.066, SRMR = 0.049); the MLR solution was consistent and favored the same model. Standardized loadings ranged from 0.814 to 0.980, and subscale reliability was satisfactory in the confirmatory subsample (α = 0.866–0.943; ω = 0.868–0.943). Academic mistreatment was the most frequently reported dimension, followed by psychological mistreatment. MQMT scores showed small-to-moderate positive correlations with symptoms of anxiety, depression, and stress, with stronger associations for academic and psychological mistreatment. Conclusions: The MQMT is a brief 16-item, five-dimensional instrument with initial evidence of validity and reliability in Mexican medical trainees. Subscale scores are the primary scores of the instrument, and the empirical distinction between discrimination with physical mistreatment and sexual harassment is not yet firmly established. Replication in other populations is needed.