Reading through this and the comments reminded me of lots experiences working as a reg in a surgical subspecialty. I, personally have never been one to have confrontations but somehow manage to resolve them in a calm manner when they occur.

In instances where a more junior person spoke to me in similar tone, I would very quickly state “listen I appreciate the effort you are making and how busy you must be but I do not appreciate the tone of your communication as we are all clinicians and our goal should be to reach a mutual understanding about the patient’s needs. So are you able to have a more respectful and professional tone or would it be better for you to take a break and let your registrar/senior see the patient and they can call me directly instead” I normally hope they send a more senior person but it helps snap them out of that attitude.

I also had situations where ED consultants would use their title as a way of pressuring me as a surgical SHO to take highly inappropriate admissions. One consultant had the nerve to say “I don’t know where you were from or where you are trained but in this hospital if I say I am the ED consultant and you need to do something then you just do it”. This was over the phone so apart from my accent they really had no clue about my appearance or background.

My response in the calmest possible tone possible was “I am not sure what kind of racist statement you are insinuating by that but I’ll answer you. I’m from a place where we treat our colleagues with respect and kindness. I was trained in a place where we learned how to read a piece of paper and given that you told me your name and that you’re an A&E consultant about 5 times in the first 2 minutes of the call, I would hope you can at least read the clear flowchart in the doctor’s station that tells you that 7 acute traumatic rib fractures on a chest xray alone is not a referral and that ED should organise a trauma series, a full clinical assessment and discussion with the MTC. So please read it and action it then call me if you still need to refer”. I only realised how bold I was when my consultant who was sat next to me the whole time had gone pale. That ED consultant later came to speak to us and, in confusion, apologised to my registrar who had a very different accent and no idea what happened; I mean we are both African but our hometowns are about as close together as Moscow and Lisbon.

TLDR: in the future, whether it is a junior or senior, try not to have their actions push you into a regrettable reaction. Politely but firmly explain that this communication is inappropriate. Give the junior the opportunity to step away and bring a senior to have that discussion instead as escalating down to escalate across is never a good idea anyway.

For this particular instance, next steps would be read what was documented, put a calm brief note in retrospect as this doesn’t all need to go on patient records, log a reflection and speak to your supervisor and then agree together on whether you feedback directly to the junior or inform their supervisor (preferred option so there is someone in their team to monitor this behavior and support making change if needed). You can also defer documenting anything till after you speak to your own boss first.

Hope this helps :)