Norfolk's largest hospital has been hit with extraordinary allegations of racist and misogynistic behaviour by senior staff towards junior colleagues.
The Norfolk and Norwich University Hospital is facing action from the General Medical Council after the regulator found serious concerns during monitoring visits..
They regulator found a culture of racism and misogyny in the hospital's medicine and surgery departments towards resident doctors.
The GMC has imposed extra monitoring and if the situation does not improve, it could stop all training in the two departments.
Prof Colin Melville, medical director at the GMC, said: "Despite ongoing work with the trust for two years, doctors in training in these departments continue to report a range of concerns, including racist and misogynist behaviours, which need to be addressed as a priority.
"There are also concerns around the clinical supervision of doctors in training, handover processes and access to educational opportunities.
"Our standards require training pathways to be fair for everyone to ensure effective training, trainee wellbeing and patient safety are maintained - but these are not currently being met.
"Our priority is to make sure doctors are receiving a high standard of training in an environment that is inclusive, supportive and fair for everyone."
Bosses at the hospital, which is rated by care watchdogs as requiring improvement, say action is already being taken to address the culture.
Among these actions, the hospital has increased the number of resident doctor places to ensure greater levels of supervision can be offered and better handovers given.
It has also introduced a resident doctors' forum to better respond to concerns, which will hold discussions focussed on reducing inappropriate behaviour.
The regulator was unable to disclose specific examples of the type of inappropriate behaviour to protect the identities of those affected and allow the trust to carry out internal investigations.
TRAINEES COULD BE REMOVED
The GMC action has seen a range of conditions placed on the two departments to ensure things improve for its trainees.
These include more stringent monitoring on training at the hospital and measures to make sure the departments have enough staff to give students the supervision they need.
Should these conditions not be met, the GMC could then remove trainees from the department altogether.
This would come as a significant blow to the hospital, with training programmes relied upon to breed the next generation of consultants and surgeons in the region.
'STAMPING IT OUT'
Prof Lesley Dwyer, chief executive of the hospital, said: "We are fully committed to improving the training and experience of all our resident doctors and we are very sorry to anyone who has experienced inappropriate behaviour.
"There is no place for racist, misogynistic or discriminatory behaviour of any kind in our organisation and we are committed to stamping it out.
"We have encouraged staff to report inappropriate behaviour so we can take action and are building on this.
"We take the conditions placed on us very seriously and all our senior leaders are resolved to make this a great place to work, train and develop."
Bernard Brett, medical director, added: "We recognise that for many of our resident doctors, the experience they have had with us is far from optimal, while we also have pockets of excellence.
"We need to ensure there is reliable high-quality training across all our specialities and we have made a £2m investment to increase resident doctor numbers in our trust this year to help reduce workload.
"Our current action plan has already delivered significant improvements, but it will take time for the impact of these changes and improvements to positively impact on our resident doctors and then show in our data."
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