title: A national study of medical students' attitudes toward self-prescribing and responsibility to report impaired colleagues.
abstract: OBJECTIVE
  The authors investigated medical students' attitudes about appropriate prescribing behaviors, their personal responsibility to report impaired colleagues, and what factors may influence these beliefs.
  
  
  METHODS
  The authors conducted a cross-sectional study of U.S. medical students in 2012 to assess attitudes about appropriate prescribing behaviors and responsibility to report impaired colleagues, and to explore relationships between prescribing beliefs and burnout, depression, and alcohol abuse/dependence. Chi-square test and multivariate logistic regression were performed.
  
  
  RESULTS
  Of 12,500 medical students invited to participate, 4,402 (35%) completed surveys. Believing it is appropriate to prescribe an antidepressant to self or spouse was rare (<10%) in comparison with believing it is appropriate to prescribe an antibiotic for oneself (34.5%) or a spouse (57.7%).In multivariate analysis, students with burnout were more likely to agree that each of the inappropriate prescribing behaviors was acceptable (ORs 1.15-1.51). Students with burnout were less likely to believe they had a personal responsibility to report colleagues with impairment due to alcohol or substance use (OR 0.87). Students personally experiencing symptoms of depression were less likely to believe medical students should report colleagues impaired by mental health problems (OR 0.72). Similarly, students with alcohol abuse/dependence were less likely to believe they had a duty to report colleagues impaired by alcohol/substance use (OR 0.55).
  
  
  CONCLUSIONS
  Suboptimal attitudes about prescribing and personal responsibility to report impaired colleagues are common among medical students. Suboptimal attitudes are associated with personal distress, further evidence of a link between personal distress and professionalism.
authors.affiliation: Dr. Dyrbye is associate professor of medicine, Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Dr. West is associate professor of medicine and biostatistics, Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Mr. Satele is a statistician, Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota. Dr. Boone was with the American Medical Association at the time of the study and is now senior director, community-based practice, Office of the Vice President for Health Affairs, University of Illinois Hospital & Health Sciences System, Chicago, Illinois. Dr. Sloan is professor of biostatistics and oncology, Health Sciences Research, Mayo Clinic, Rochester, Minnesota. Dr. Shanafelt is professor of medicine, Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Liselotte N
authors.initials: LN
authors.lastname: Dyrbye
authors.forename: Colin P
authors.initials: CP
authors.lastname: West
authors.forename: Daniel
authors.initials: D
authors.lastname: Satele
authors.forename: Sonja
authors.initials: S
authors.lastname: Boone
authors.forename: Jeff
authors.initials: J
authors.lastname: Sloan
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
mesh_terms: D001291:Attitude of Health Personnel; D002055:Burnout, Professional; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D016015:Logistic Models; D001523:Mental Disorders; D015999:Multivariate Analysis; D010815:Physician Impairment; D012941:Social Responsibility; D013337:Students, Medical / Q000523:psychology*; D019966:Substance-Related Disorders; D014481:United States