Hierarchy, Silence, and Survival Mode: The Real Cost of Being Agreeable in Medicine

In this week’s Social Rounds, Tony & Frances Mei pull back the curtain on one of medicine’s worst-kept secrets: sycophancy. Why do so many trainees learn to smile, nod, and swallow their opinions? And how did we get to a place where disagreeing with an attending feels riskier than doing the wrong thing?

They unpack the unwritten rules of hierarchy — the quiet calculations trainees make to stay safe, the way questionable comments get brushed aside, and how all of this chips away at psychological safety and moral clarity. Along the way, they swap stories, compare notes, and even draw parallels between medical trainees and AI: two systems trained to please instead of push back.

It’s honest, a little uncomfortable, and very on-brand for Social Rounds — a conversation about power, integrity, and whether medicine is finally ready for a culture where people can say the quiet truth out loud.

Hosted by:

Tony Chin-Quee: @wheyouat

Frances Mei Hardin: @francesmeimd

Produced by: The Hippocratic Collective