In a conference room at the Drake Hotel in Chicago, female physicians across all levels — residents, attendings, leadership — discussed their experiences with workplace bullying. Some described being pushed out of jobs, others detailed toxic environments co-signed by their bosses, and some expressed regret about how pent-up frustration led them to not-so-positive confrontations with colleagues.

The group was there to listen to Breanne Jacobs, MD, give her talk: “Mean Girls in Medicine” at the 2025 Women in Medicine Summit (WIMS). Afterward, Jacobs opened the floor to allow attendees to talk about their experiences with bullying.

What was apparent was how cathartic it was to share these personal stories. What was surprising was that many, though not all, of these anecdotes centered around female supervisors and colleagues. In fact, it seemed to create a more visceral impact when the bullying came from other women.

It’s an issue that hides — often in plain sight — in the medical field. “I’m not an expert in bullying. I wanted to highlight an issue I’ve noticed and one that is not talked about enough. Most importantly, I wanted to let others have a space where they could share with each other and know they’re not alone,” said Jacobs, a clinical assistant professor of emergency medicine at the George Washington University Medical Faculty Associates in Washington, DC.

Discussions around bullying in healthcare aren’t new. In nursing, the problem has even been dubbed an “epidemic.” But this toxicity continues to interrupt the professional growth of healthcare workers across all areas of medicine. A 2023 research article in the Journal of Women’s Health surveyed female physicians who held prominent roles in academic medical institutions. The study found that 85% of female respondents reported experiencing mistreatment during their careers, most often by their supervisors.

“This study in itself speaks to the pervasiveness of the problem. It’s one of the few studies that look at the pervasiveness of bullying by gender,” said co-author Maya Iyer, MD, MEd, associate clinical professor of pediatrics at Nationwide Children’s in Columbus, Ohio, who has researched the issue of bullying in medicine.

The fallout, reported in the 2023 paper, includes harm to career advancements, mental health, reputation, and relationships with other people, sometimes forcing those who were bullied to change their role or leave their job altogether.

In fact, while female physicians freely shared their personal experiences at the WIMS seminar, few felt safe speaking publicly with Medscape Medical News for this article, fearing professional repercussions.

When Women are the Bullies

Female-on-female bullying can feel uniquely impactful. But it may not be what you’d expect from a stereotypical offender. “Women bullying is often characterized by social and psychological exclusion, whereas typically male bullying is characterized as physical aggression, more overt, and generally less tolerated in a professional environment,” said Jacobs.

That said, Jacobs points out that the most common form of bullying, from either sex, is exclusion, an insidious form of hostility that tends to simmer under the surface. As she explains, exclusion shows up in several ways: from work meetings to social gatherings with colleagues to collaborations that could lead to research opportunities or professional advancement. Being pushed out of those settings means you have no seat at the table — and you may have to focus on surviving, not thriving, where you are.

Leadership roles in major medical centers are still dominated by men, even though more women have entered medicine, research showed. “Being in the minority, female physicians may feel they should ‘look out for one another’ or ‘stick together’ against the male hierarchy,” said Jacobs. “However, when relational aggression occurs among female physicians, they may feel excluded both socially and professionally, and the negative psychological effects can be significant.”

This is something that Rebecca Hellmann, DO, an emergency medicine physician at Weill Cornell Medicine in New York City watched happen first-hand. It’s well-known that pregnancy as a physician may come with a higher risk for complications, negative perceptions from peers, and scheduling challenges. For emergency medicine residents, in particular, working night shifts — particularly cumulative ones — is linked to higher odds of preterm delivery and miscarriage.

That’s where Hellmann wanted to make a change. “We were trying to pass a pregnancy scheduling policy to ensure the health and safety of our co-residents. We found that the loudest voice of opposition was coming from other females, particularly other females who were pregnant,” she explained.

The women who were against changing the policies countered with arguments like “we’re not made of glass. We’re tough. We’re badass emergency physicians!” said Hellmann, who thought, “Yes, you are, but what if someone else isn’t?’ We still need to protect others who might not want to work these shifts or are more at risk. This made me realize how much more important it is to be an advocate for women even if I didn’t share the same experiences as them,” she said.

Queen Bees in Healthcare?

Stereotypes of aggressive professional women may fuel expectations that women will walk all over each other if given the chance. This was named decades ago as the “Queen Bee” notion. It refers “to women in leadership positions who distance themselves from other women and maintain the status quo, often denying the existence of gender discrimination in the process.”

In a way, that makes sense, said the authors of a 2020 article in The Lancet. If there is only token representation of women in medical leadership, women at the top may adopt more “masculine traits” or act poorly toward fellow women. The authors argue that this behavior is the product of an environment that promotes these gender biases.

Overall, the Queen Bee theory may not be as iron-clad as the stereotype suggests. As The Lancet paper points out, empirical evidence actually shows that when women get to the top, they’re more likely than men to support other women and create more supportive networks.

But the problem persists. In Iyer’s research, about 22% of bullies in academic medicine were female peers. The remaining were male superiors or colleagues, making men the most common bullies. However, “personal stories revealed that some of the worst bullies were female-on-female. Statistics might not be there, but the stories are,” said Iyer.

Some of the common themes the women discussed included blocking promotions and leadership opportunities, spreading rumors in public and private meetings, and withholding resources, such as admin, support, staff, and data, said Iyer.

‘Are We Just Expected to Be Nicer?’

The percentage of female-on-female bullying isn’t the entire story. Hellmann points to a 2024 survey by the Workplace Bullying Institute that found that 18% of bullying was woman-on-woman, but — and here’s the kicker — 51% of bullied targets were women. “Meaning, women are still the majority target no matter what the gender of the bully,” she said.

It’s also important to think about what is perceived as bullying behavior. “Men can do and say the same thing, and it’s not considered bullying. When a woman does it, it’s considered bullying because of the expectation we have for how women should behave in the workplace,” Hellmann explained.

There’s a dichotomy where critical feedback comes off as harsh and unlikeable, said Hellmann. “Are we bullies, or are we just expected to be nicer?”

Women are generally quicker to spot mistreatment in all forms. “Some studies suggest that women tend to be more sensitive to social exclusion than men, which is why women may be more inclined to recognize bullying behavior,” said Jacobs.

How to Handle a Bully

In many bullying situations, it’s likely that the bully’s real problem is internal. Hellmann points to research in Psychological Science that found that women with “high envy” feel the need to compete for resources by disparaging “rivals,” but those with “low envy” deal with the competition by using self-promotion. “If you have a lower idea of self, you might put others down, but if you feel confident that you’re the right person for the job or deserve a promotion, you don’t care about other people,” she said.

Taking action can be the hardest step, in part because the person being bullied is often shocked by the experience. “It’s frustrating because you’d think that in a professional environment you should be beyond it, but unfortunately it’s happening, and when you experience it, you don’t know what to do about it,” Jacobs said.

Although the quickest way to resolution is to approach the other person, it is the most uncomfortable and risky because you have no idea how they’ll respond, Jacobs said. “You don’t have to be quiet,” she advised. “You can respond and stand up for yourself in a way that’s respectful and professional.” If you have access to counseling, individual or group therapy sessions can help you develop coping strategies or, at the very least, feel less alone.

If you are a leader in the room, this is your opportunity to clear a pathway for someone else, set an example, and even offer coaching to effect change, said Jacobs. Part of the explanation of why bullying is so rampant, which Iyers’ research explores, is that it is passed down, creating a cycle that normalizes bad behavior. It becomes a “this is how it is” culture that’s tough to reverse.

“People are very stressed and on short fuses because they’re constantly overworked, tired, and burned out, and those doing the bullying are not held accountable,” Jacobs added. There is evidence that only about one quarter of victims report bullying in academic medical settings. “It’s critical,” said Jacobs, “for leaders in the organization to believe people who report bullying, set an example of a culture where it’s not tolerated, and provide needed training.”

As you progress and climb the ranks in medicine, be the voice amplifying other women where you can make a difference, said Hellmann. “As I got into different rooms and meetings, I had this need to make sure that women felt supported, especially since there are fewer of us in there.” There may be a way to connect with a hostile colleague and find common ground. After all, the goal you both share is providing the best care for patients.