Medical students' attitudes toward providing care for the underserved. Are we training socially responsible physicians?
OBJECTIVE
To investigate the association between attitudes toward caring for the medically indigent and years of medical training.


METHODS
Questionnaire comparing attitudes of first-year medical students (MS-Is) and fourth-year medical students (MS-IVs).


METHODS
Southwest medical school.


METHODS
A total of 83 (67%) male and 41 (33%) female MS-I and 65 (73%) male and 24 (27%) female MS-IV volunteers.


METHODS
Self-report, attitudinal scale developed for this study that provided a measure of overall attitudes, perceived societal expectations, physician/student responsibility, personal efficacy, and provision of basic services and expensive procedures.


RESULTS
Overall attitudes were significantly less favorable for MS-IVs (95% confidence interval [CI], 99.6 to 106.2) than MS-Is (95% CI, 109.5 to 114.3, P < .0001). Except for basic services (P = .46), MS-IVs had worse attitudes on all attitudes subscales. Male MS-IVs reported significantly less favorable attitudes than male MS-Is in the areas of general attitudes (P = .03) and physician/student responsibility (P = .01). Female medical students showed no significant differences across classes (P > .05). Except for physician/student responsibility, female medical students' attitudes were more favorable than those of males, regardless of class.


CONCLUSIONS
The MS-IVs are less favorably inclined toward caring for the medically indigent than MS-Is, though these differences are apparent only for males. Further research is needed to explore why females appear to be more resistant to attitude changes, and what educational interventions are necessary to better train physicians to respond to national health care issues.
Crandall
S J
SJ
Department of Family Medicine, University of Oklahoma Health Sciences Center, Oklahoma City 73104.
Volk
R J
RJ
Loemker
V
V
D001291:Attitude of Health Personnel; D004501:Education, Medical / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008489:Medical Indigency / Q000523:psychology*; D035863:Moral Development; D028681:Moral Obligations; D010822:Physicians, Women / Q000523:psychology; D012941:Social Responsibility; D015206:Southwestern United States; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires