title: Effect of a global longitudinal pathway on medical students' attitudes toward the medically indigent.
abstract: BACKGROUND
  The increase in people with insufficient health insurance has largely been fueled by a record influx of immigrants, who often live in medically underserved areas of inner cities. An increase in the desire of medical students to practice in underserved areas is needed to counter low physician-to-population ratios in these areas.
  
  
  OBJECTIVE
  To assess the effect of a Pathway on Serving Multicultural and Underserved Populations, which includes domestic and international experiences with recent immigrant groups, on the attitudes of students toward the indigent.
  
  
  METHODS
  Students from the classes of 2002 and 2003, including a cohort in the Pathway program, were participants in this study. Changes in attitudes within Pathway and non-Pathway students were studied over their 4 years of medical school.
  
  
  RESULTS
  There was no statistically significant difference between the two groups in the rate of change of attitudes over time. The determination of any potential difference was hampered by small sample sizes. Thus, interesting trends, especially related to a more rapid decline in attitudes of non-Pathway students, including their sense of professional responsibility, did not achieve statistical significance.
  
  
  CONCLUSIONS
  Further research, both quantitative and qualitative, is needed before we can state more definitively that the Pathway curriculum supports positive attitudes toward serving the medically indigent.
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA. michael.godkin@umassmed.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Godkin
authors.forename: Judith A
authors.initials: JA
authors.lastname: Savageau
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Fletcher
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D018864:Cultural Diversity; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008489:Medical Indigency; D008507:Medically Underserved Area; D017057:Medically Uninsured; D011203:Poverty; D012946:Social Welfare; D013337:Students, Medical / Q000523:psychology*; D014195:Travel