Shame in Medicine

Shame is a feeling that happens when we judge ourselves as flawed or wrong in some important way. It can follow experiences like feeling that we have failed, being criticised, or being mistreated. Shame happens when we then interpret this event as revealing something global and unchanging about ourselves, such as our ability, character, or worth. In this way, shame can bring painful feelings of defectiveness, unworthiness or inadequacy.

 

Shame is an umbrella term that describes a range of emotions such as embarrassment, humiliation, inferiority, self-consciousness, and feeling disrespected. Shame can be hard to recognise as these experiences may look quite different, but they have several common factors: feeling judged, less worthy, or falling short of expectations. Shame can motivate positive behaviour change, but when it becomes persistent or unhealthy, it can damage our wellbeing and relationships with others. Healthcare professionals commonly experience shame during training and practice, often due to entrenched hierarchies, the human costs of perceived "failure", and uncertainty about achievement and belonging within the profession.

Shame in Lothian 

In 2025, we surveyed FY2s to understand the local experience of shame. We received 29 responses over 5 months and 93% of respondents reported experiencing shame in the context of their medical work or training in NHS Lothian. 48% of those respondents felt that their experience of shame in NHS Lothian had a significant negative impact on them. We found that respondents had experienced shame during interpersonal interactions (e.g. feeling mistreated - 50%), in the course of their learning and training (e.g. difficulty keeping up with workload - 82%), and within their clinical work (e.g. making a clinical error - 88%).

Shame Competence

Now that we understand more about shame, its definitions and its consequences, we need to understand how we can mitigate its potentially damaging effects. The shame competence framework provides guidance on how we can achieve this:

  1. Be aware of the potential for shame​

  2. Recognise when shame might be occurring​

  3. Avoid inducing shame​

  4. Provide proactive support​

  5. Transform organisations

The MED team will be presenting our project findings and implementation plan at Grand Rounds on Wednesday 26 August 2026. The session will be recorded and shared on the Events page of the MED website in case you miss it.

Support

For trainees – if you are experiencing shame in the context of your education and training, speak to your supervisor.

For trainers – see our Resources to Help You Support Trainees.

Resources

Further reading

You said...We did

This infographic provides a neat summary of the work we have undertaken within Lothian: