Abstract
INTRODUCTION: Academic bullying of junior doctors undermines trainee wellbeing and patient care, yet little is known about its manifestation in Sierra Leone. This qualitative study explored the experiences, perceptions, and coping strategies of junior doctors subjected to academic bullying at the University of Sierra Leone Teaching Hospitals Complex (USLTHC). METHODS: Guided by a social-constructivist paradigm, we conducted semi-structured interviews with 29 junior doctors across major hospitals that comprise the USLTHC. Data were collected between July 20 and August 31, 2024, using an English-language interview guide. Thematic analysis was undertaken with NVivo software. RESULTS: Eight inter-related themes emerged: (1) entrenched clinical hierarchies, (2) overt verbal abuse and humiliation, (3) punitive workloads and extended shifts, (4) lack of institutional safeguards, (5) psychological distress, (6) threatened career progression and attrition, (7) reliance on peer-support coping, and (8) proposed remedies, notably teacher-training for seniors and enforceable anti-bullying policy. Bullying was framed as a cyclical "rite of passage" perpetuated by fear of retaliation and scarce reporting channels. CONCLUSION: Academic bullying at USLTHC is systemic, culturally rationalised, and exacerbated by resource constraints. Embedding enforceable anti-bullying policies, structured faculty-development, and accessible mental-health services is essential to protect trainees and protect Sierra Leone's evolving health-workforce.