A new study finds hospital staff routinely crack jokes at the patient’s expense while medical students learning about professionalism get mixed messages.

Researchers at Northeastern Ohio University’s College of Medicine interviewed 58 medical students at the Rootstown, Ohio, campus about behavior they engaged in or witnessed.

Many said the most obese patients, the mentally ill, men with small penises, women with big breasts, substance abusers and those who injured themselves doing something stupid were the most likely the butt of jokes.

The Cleveland Plain Dealer reports terminally ill patients, especially young cancer patients, were left out of any ridicule.

The study, led by Dr. Joseph Zarconi, associate dean for clinical education at the medical school, said students are taught one way to behave in the classroom and see another in person.

They get mixed messages. To play the game means participating in the humor game, said Zarconi.

The study, published in Tuesday’s issue of Academic Medicine, showed jokes weren’t made around patients. It found those who made jokes said some patients deserved to be made fun of.

Others said it was a way to relieve stress.