title: Decline of medical student idealism in the first and second year of medical school: a survey of pre-clinical medical students at one institution.
abstract: BACKGROUND
  Idealism declines in medical students over the course of training, with some studies identifying the beginning of the decline in year 3 of US curricula.
  
  
  OBJECTIVE
  This study tested the hypothesis that a decline in medical student idealism is detectable in the first two years of medical school.
  
  
  METHODS
  We sought to identify differences in survey responses between first-year (MS1) and second-year (MS2) medical students at the beginning (T1) and end (T2) of academic year 2010 on three proxies for idealism, including items asking about: (a) motivations for pursuing a medical career; (b) specialty choice; and (c) attitudes toward primary care. Principle component analysis was used to extract linear composite variables (LCVs) from responses to each group of questions; linear regression was then used to test the effect of on each LCV, controlling for race, ethnicity, rural or urban origins, gender, and marital status.
  
  
  RESULTS
  MS2s placed more emphasis on status/income concerns (β=0.153, p<0.001), and much less emphasis on idealism as a motivator (β=-0.081, p=0.054), in pursuing a medical career; more likely to consider lifestyle and family considerations (β=0.098, p=0.023), and less likely to consider idealistic motivations (β=-0.066, p=NS); and were more likely to endorse both negative/antagonistic (β=0.122, p=0.004) and negative/sympathetic (β=0.126, p=0.004) attitudes toward primary care.
  
  
  CONCLUSIONS
  The results are suggestive that idealism decline begins earlier than noted in other studies, implying a need for curricular interventions in the first two years of medical school.
authors: Department of Family Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA. morleycp@upstate.edu
authors: Christopher P
authors: CP
authors: Morley
authors: Carrie
authors: C
authors: Roseamelia
authors: Jordan A
authors: JA
authors: Smith
authors: Ana L
authors: AL
authors: Villarreal
mesh_terms: D000533:Altruism; D001290:Attitude; D002321:Career Choice; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009042:Motivation; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States
keywords: career choice; idealism; medical students; surveys
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