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Context: Medical school experiences undoubtedly affect and change specialty choice by medical students. Objective: To document and compare changes from matriculation to graduation in the choice of family medicine versus other specialties among US medical students in four recent graduating classes. Study Design and Analysis: Comparison of specialty choice surveys completed by US medical students at graduation and at matriculation. Dataset: 2018-2021 graduation questionnaires and corresponding matriculation questionnaires administered by the Association of American Medical Colleges (AAMC). Population studied: Graduating medical students from all LCME-accredited US medical schools from 2018-2021. Instrument: 2018-2021 AAMC Medical School Graduation Questionnaire and corresponding Matriculating Student Questionnaires. Response rates for these surveys ranged between 70 and 79.4%. Outcome Measures: Proportion of students choosing family medicine at graduation who had chosen it at matriculation, compared to the proportions for other specialties and to the total of all specialties. Results: For the four years studied (2018-2021), an average of 26.1% (range 25.6-27.0%) of all graduating students who indicated a specialty had selected the same specialty when they matriculated. The four-year average for family medicine, 28.6% (range 27.5-30.3%), was slightly higher than the overall average. Pediatrics, by comparison, averaged 41.7% (range 39.1 to 43.0%). The highest maintenance of specialty choice was for orthopedic surgery, which averaged 47.4% (range 44.8% to 50.2%) over the four surveyed years. Conclusions: Understanding the factors that influence and affect specialty choice would be important and useful in addressing specialty shortages in the US. In this study, about a quarter of all students who indicated a specialty choice at graduation had listed the same specialty at matriculation. Family medicine was slightly higher than that, but orthopedic surgery had the highest percentage, considerably higher than average. It would also be interesting to have data for the inverse of this analysis: i.e., the proportion of those choosing family medicine (and other specialties) at matriculation who then indicated the same specialty at graduation., Presenters Douglas Kamerow, MD, MPH, Gisela Delgado-Rosado, MD, john westfall, MD, [...]

Byline: Ishani. Patel, Jalpan. Patel, Siddharth. Jindal, Devangi. Desai, Soaham. Desai Background: Current undergraduate medical academic curriculum does not emphasize on evaluation and management of dementia. The knowledge and attitude [...]

Introduction: Despite healthcare providers' growing awareness of pre-exposure prophylaxis (PrEP), prescription rates remain low. PrEP is an efficacious HIV prevention strategy recommended for use with condoms but still protective in their absence. Concern about the impact of PrEP on condom use and other risk behaviour is, nonetheless, among the barriers to prescription commonly reported. To understand the implications of this concern for PrEP access, we examined how medical students' willingness to prescribe PrEP varied by patients' condom use and partnering practices. We also assessed the perceived acceptability of various reasons for condom discontinuation with PrEP. Methods: An online survey was distributed to 854 medical students in the Northeastern US in 2015. Participants (n = 111) were surveyed about their willingness to prescribe PrEP for each of six male patients who systematically differed in their reported condom use (sustained use, sustained nonuse, or discontinuation with PrEP) and partnering practices (single male partner with untreated HIV or multiple male partners of unknown HIV status). Participants also reported perceived acceptability of four reasons for condom discontinuation: pleasure, sexual functioning, intimacy, and conception. Results: Willingness to prescribe PrEP was inconsistent with patient risk: When the patient used condoms and planned to sustain condom use, most participants were willing to prescribe PrEP--93% if the patient had a single partner and 86% if the patient had multiple partners. Fewer were willing to prescribe if the patient did not use condoms and planned to sustain nonuse (53% and 45%, respectively) or used condoms but planned to discontinue use (27% and 28%). Significantly fewer participants were willing to prescribe for a patient with multiple partners versus a single partner when the patient reported sustained condom use or sustained condom nonuse.The number of participants who were willing to prescribe was similarly low for a patient with multiple partners versus a single partner when the patient reported that he planned to discontinue condom use. More participants accepted a patient discontinuing condoms for conception (69%) than for intimacy (23%), pleasure (14%), or sexual functioning (13%). Conclusion: Medical students' clinical judgments were misaligned with patient risk and suggest misconceptions or personal values may undermine provision of optimal HIV prevention services. Keywords: HIV; pre-exposure prophylaxis; healthcare disparities; prescriptions; health personnel; sexual minorities, 1 | INTRODUCTION Pre-exposure prophylaxis (PrEP) is an efficacious HIV prevention strategy [1]. US clinical guidelines cite condomless sex as a key indicator of HIV risk and PrEP candidacy [2]. [...]

Byline: Bashaer. Alsaati, Maram. Aljishi, Sunds. Alshamakh, Nujood. Banjar, Hadeel. Basharaheel, Rawan. Alamri Introduction: Do not resuscitate (DNR) is a medical procedure for patients who are suffering from critical, untreatable, [...]

Byline: Samia. Ellias, Henal. Shah Aims: This study is to study the knowledge and awareness on autism among medical students and the factors which impact their knowledge on autism. Settings [...]

Climate change is recognized as a major public health threat. Health care services are major contributors to carbon emissions. Future doctors will make clinical decisions that have consequences for the environment. However, there is no research on the views of future doctors on climate change. In this focus group study with 24 current medical students we explored climate change and health, and the role of future doctors in responding to climate change. Not all students accepted the evidence for climate change although most were aware of the implications (if it were to occur) for health. Most students thought international agreements were needed to reduce carbon emissions. All students considered doctors to be influential in society, but there was no consensus on whether and how doctors should use this influence in relation to climate change. Many future doctors remain unconvinced about climate change and are unclear about their role and responsibilities., Introduction Climate change is considered a major public health issue for the 21st century (Costello et al., 2009). Direct effects on health include increasing morbidity and mortality from effects of [...]

Historically, osteopathic medicine has focused primarily on clinical medicine. Research was a secondary concern, although scientific inquiry was originally part of the vision of founder Andrew Taylor (A.T.) Still, MD, [...]

With the rising incidence of HIV/AIDS in China, nurses will increasingly be caring for patients with HIV/AIDS. Thus, it is necessary that they have enough knowledge to reduce the risk of occupationally acquired HIV infection and that they change their attitude to care for HIV/AIDS patients. The objective of this study is to explore the relationship between student nurses' HIV/AIDS knowledge and their attitude using a structural equation model (SEM). A cross-sectional survey was conducted in January 2008 among 528 student nurses at the technical secondary school of the China Medical University. An SEM is proposed to determine the direction and magnitude of the interdependent effects between the latent factors. The SEM was built using LISREL version 8.5. The measurement properties of the latent factors underlying the questionnaire were based on a confirmatory factor analysis (CFA). Our results as following, HIV/AIDS knowledge and attitude may be measured by seven underlying constructs, namely, preventive knowledge, knowledge of transmission routes, specialty knowledge, knowledge of nontransmission routes, positive attitude toward HIV/AIDS, negative attitude toward HIV/AIDS, and occupational attitude. The SEM fits the data well. The interdependent relationships between these constructs identified the factors of preventive knowledge, specialty knowledge, and attitude toward HIV/AIDS as having both direct and indirect effects on occupational attitude. In conclusions, our results represent an initial effort to assess the relationship between student nurses' HIV/AIDS knowledge and their attitude toward the disease. CFA and SEM analysis have demonstrated their usefulness in evaluating multifactor complex constructs. DOI: 10.1089/apc.2009.0190

Objective: The purpose of this study was to identify and investigate the factors derived from the rural integrated community clerkship (RICC) questionnaire that influenced the decision of medical students to pursue a 36-week rural community placement option. Methods: A total of 162 first-year (n = 92) and second-year (n = 70) medical students completed the 35-item RICC questionnaire. We used qualitative interviews to develop questionnaire items, and we used subsequent descriptive statistics and exploratory factor analyses to analyze the data. Results: Students with origins in rural communities were not significantly more likely to consider a RICC than their urban counterparts. However, students who identified family medicine as their discipline of choice were 3 times more likely to consider a RICC. Exploratory factor analysis, based on correlation of questionnaire items, determined 7 factors (themes) for the questionnaire. The questionnaire had strong internal reliability (Cronbach [alpha]= 0.94). Conclusion: Although generally supportive of the rural clerkship option, students are less concerned about the clinical experience than they are about the practical implications of moving to a rural community. The RICC questionnaire was shown to have strong reliability and construct validity in measuring students' perceptions of a long-term clerkship placement in a rural community. Objectif : Cette etude avait pour but de reperer et d'analyser au moyen du questionnaire sur le stage clinique integre en milieu communautaire rural les facteurs ayant influence la decision des etudiants en medecine d'opter pour un stage en milieu rural de 36 semaines. Methodes : En tout, 162 etudiants en medecine (premiere annee, n = 92, et deuxieme annee, n = 70) ont repondu au sondage en 35 questions sur le stage clinique integre en milieu communautaire rural. Nous avons prepare les elements du questionnaire a partir d'entrevues qualitatives et nous avons utilise des statistiques descriptives et des analyses de facteurs exploratoires subsequentes pour proceder a la synthese les donnees. Resultats : Les etudiants originaires de communautes rurales n'ont pas semble significativement plus susceptibles d'envisager un stage clinique integre en milieu communautaire rural que leurs collegues citadins. Toutefois, les etudiants qui avaient choisi la medecine familiale etaient 3 fois plus susceptibles d'envisager un stage clinique integre en milieu communautaire rural. L'analyse des facteurs exploratoires fondee sur une correlation entre les elements du questionnaire a permis de recenser 7 facteurs (themes) pour le questionnaire, qui comportait au demeurant une forte fiabilite interne (coefficient [alpha] de Cronbach = 0,94). Conclusion : Bien que generalement favorables a l'option de stage clinique en milieu rural, les etudiants semblent moins preoccupes par le contenu clinique que par les repercussions de leur demenagement en milieu rural. Le questionnaire sur le stage clinique integre en milieu communautaire rural s'est revele dote d'une fiabilite et d'une validite conceptuelle suffisamment solides pour rendre possible une evaluation des perceptions des etudiants quant a l'option d'un stage clinique prolonge en milieu rural., INTRODUCTION It is clear that the shortage of primary care physicians has become critical in rural communities. In general, the 2 most important factors that have been linked with a [...]

Findings from adoption, family, geographical, immigrant, molecular genetic, surname, and twin studies suggest genetic risk factors have a role in suicidal behavior. However, related mental health literacy (knowledge and beliefs) even of future health-care professionals who will be concerned with suicide lag behind this research progress. As no scale for assessing such beliefs is available, the 22-item Beliefs in the Inheritance of Risk Factors for Suicide Scale was constructed, its contents rated by experts in a validation survey and administered to samples of 70 medical and 165 psychology students. Medical students held stronger beliefs in the genetics of suicide than psychology students. Internal scale consistency and test-retest reliability were assessed as adequate. Factor analysis of the 22 items yielded a dominant first factor. Scores were positively related to knowledge about suicide (convergent validity) but for the most part unrelated to lay theories of suicide, political orientation, religiosity, and social desirability (discriminant validity). This novel scale shows potential for assessing individuals' beliefs about the genetics of suicide. Applications may include basic research, educational contexts, and evaluation of professional training.

The article presents the results of a study on beliefs about wife beating conducted among 476 Sri Lankan medical students. Participants fill out a self-administered questionnaire, which examines six beliefs about wile beating. Most students tend to justify wife beating, to believe women benefit from wife beating, and to believe the wife bears more responsibility than the husband for violence against her. At the same time, most participants express willingness to help battered women. However, the vast majority oppose divorce as a solution to wile beating and are against punishing violent husbands. The results also reveal that a significant amount of the variance in each of the six beliefs are best explained by the students' patriarchal approach toward women and marriage and by their exposure to violence in their families of origin. The implications of the results for future research and theory development on beliefs about wife beating are discussed. Keywords: wife abuse; wife beating; beliefs about wife beating; students of medicine; Sri Lanka

Despite convergent evidence for a role of genetic risk factors for suicide stemming from quantitative genetic (family, twin, and adoption designs), molecular genetic, and geographical studies, professionals, likely to be exposed to suicide, appear to disbelieve strongly in the inheritance of risk factors for suicide. In a sample of 1,093 Austrian medical and psychology students, about 80% of respondents did not endorse genetic risk factors for suicide, regardless of their sex, age bracket, field and year of study, and overall knowledge on suicide facts. This may reflect educational gaps, cognitive biases against genetic bases and explanations, or both. One single implication is that this information needs to be incorporated and covered more visibly in medical and psychology textbooks and curricula.

Clinical practica are essential to the training and socialization of future clinical and counseling psychologists. When training expectations are not met, however, students may not be candid about these gaps, instead opting to grin and beat-it. A sample of 321 doctoral psychology students responded to a survey that qualitatively and quantitatively assessed their expectations and actual training experiences at practicum. Results indicated that although many students received what they expected, a large minority did not, in areas ranging from work responsibilities to primary supervision, Implications for students, practicum, graduate programs, and the profession are discussed. Keywords: practica, externship, psychology, training, feedback

To study the attitudes and personal experiences with Traditional Chinese Medicine (TCM) use in pharmacy students. Design: Prospective cross-sectional study. Setting: University School of Pharmacy. Methods: Pharmacy students were asked 17 questions according to an anonymous survey questionnaire. Results: All 91 students (46% males) participated in the survey. The attitude toward TCM use was positive in 40%, neutral in 59% and negative in only 1%. On scales from 0 to 10, the mean (SD) scores for the adequacy of the current curriculum in TCM training and state of TCM knowledge were 3.2 (2.0) and 3.6 (1.6), respectively. Of the 35 participants who had used TCM in the past year, nearly half did so without any TCM practitioner consultation. Seventy-four percent reported that they had not been told of any side effects of TCM. When comparing the third year with first or second year students, there was no significant difference between any of these findings. Conclusion: The training in TCM within this 3-year pharmacy curriculum appears inadequate. Most students are not aware of any possible side effects in TCM. The attitude and practice do not appear to vary significantly between successive year of pharmacy students. KEYWORDS Pharmacy students; Attitude; Traditional Chinese Medicine use

Purpose: This study examined medical students' interest in geriatrics: Are knowledge, positive attitudes, and prior experience with older adults associated with an interest in geriatric medicine? Design and Methods: Entering University of Michigan medical students completed three surveys: the Revised Facts on Aging Quiz, the University of California at Los Angeles Geriatric Attitudes Scale, and the Maxwell-Sullivan Attitudes Scale. The students were also asked questions about their prior experience with older adults and their interest in geriatric medicine. Results: The results indicate that incoming medical students have minimal knowledge about aging, moderately positive attitudes toward older adults, and low interest in geriatric medicine. Having more positive attitudes toward older adults ([beta] = .28) and having cared for older persons prior to medical school ([beta] = .14) were associated with greater interest in geriatric medicine. Implications' These findings suggest that interventions to increase the number of geriatric-oriented physicians should focus on influencing learners' attitudes through experiences in the care of older adults. Key Words: Prior experience, Practice preference

This study is a preliminary comparison of the attitudes of osteopathic medical students, medical school faculty, primary care providers, and the general population toward seeking professional psychological help. Attitudes were also studied in the former three groups for those who had and had not previously received mental health services. 103 medical students, 22 faculty, 31 primary care providers, and 395 people from the general population responded to the mail-out survey. Attitudes toward help-seeking were more negative among the general population group than among students and providers. For these students, faculty, and providers, attitudes toward seeking help were more positive if they reported having received mental health services in the past.

Despite the fact that cigarette smoking in East Europe is a major health problem, no effective health policy responses have been developed thus far. Health care professionals represent a valuable resource for tobacco control. Therefore, we wanted to obtain information about the acceptance of smoking among medical, nursing and pharmacy students (n = 270) in Szeged, Hungary. The self-administered questionnaire contained items on smoking behavior, beliefs and attitudes related to smoking. [chi square]-test were used to determine differences in the attitudes among students. Smoking was the most frequent among nursing students, followed by medical students. Pharmacy students not only reported smoking the least but they also showed the most acceptable attitudes toward smoking. The high frequency of smoking among students suggests that they themselves are unable to cope with avoiding the dangers of smoking. Moreover, responses reflect a generally poor appreciation of responsibility that health care professionals have in prevention. There is a need for an increasing emphasis on smoking-related attitude formation among medical and nursing students. KEY WORDS: smoking; attitudes; health care professionals; medical students.

A study was conducted with 154 Malaysian medical students to assess the extent to which their attitudes and knowledge about smoking changed over the course of their training. The results showed that women's knowledge and attitudes had improved. Male non-smokers knowledge improved but not their attitude while smokers did not improve on either scale. Women and male non-smokers improved their knowledge and attitudes about environmental tobacco but smokers did not. Attitudes were influenced by peers but not by family or teachers.

Many medical students, faculty and deans have a negative attitude toward managed care. Researchers surveyed 506 medical students, 494 medical residents, 728 faculty members and 105 medical school deans. On a scale from 0 to 10, the average scores for managed care ranged from 3.9 among residents to 5 for deans. Most respondents preferred fee-for-service over managed care for specific aspects of medical care, including continuity of care, access to health services, the doctor-patient relationship, end-of-life care and care of chronic illnesses. Many faculty members admitted that they passed their negative assessment of managed care to their students.

'Good morning. Listen up!' All eyes focus on the stocky chief resident as he balances a paper coffee cup on a towering stack of charts. He scans his fresh crop [...]

Byline: Geetanjali. Chilkoti, Medha. Mohta, Rachna. Wadhwa, Ashok. Saxena, Chhavi. Sharma, Neelima. Shankar Background and Aims: Students are exposed to basic life support (BLS) and advanced cardiac life support (ACLS) [...]

Byline: Mohammad. Asadpour, Laya. Sabzevari, Asadollah. Ekramifar, Reza. Bidaki Aim: Attitude toward death is one of the most important factors that can influence the behavior related to the health profession. [...]

Byline: Parul. Jindal, Gurjeet. Khurana Background and Aims: The scenario in medical education is changing with objective structured clinical examination (OSCE) being introduced as an assessment tool. Its successful implementation [...]

An unanswered question in previous research on attitudes to health care systems is whether the values held by medical students are unique to them or simply a cohort phenomenon. This study addresses this by measuring values and attitudes on entry to medical school, and comparing them with two other groups whose academic standing at entry and social status are likely to be comparable - business and law students. In this paper four substantive areas are dealt with: managed care, cost controls such as rationing, access to care, and the role of the federal government in regulating health care. There was a high level of agreement between the three groups that society should provide health care to all citizens, and that individuals should have appropriate access. There was also a general preference for being treated in a fee-for-service setting. Some differences were that medical students held more negative views about managed care than some of the others. The students tended to disagree on cost controls, particularly on issues that might impact on their own professions. Medical students were more restrictive than others on concepts of rationing health care and with regard to high tech procedures. Thus the results reflect areas of extensive agreement, but also the fact that even at entry students may differ on issues that are likely to have an economic impact on their careers. The relationship of these attitudes to the changing health care system and to theories about professionalism and the state is discussed. Key words - medical students, attitudes, health care system, professionalism

To investigate why some caregivers desire to avoid patients with terminal illnesses, a thanatophobia scale assessing caregivers' uncomfortable feelings and sense of helplessness was developed and evaluated among practicing physicians and student nurses and medical students. As a group, student nurses scored lower on the thanatophobia scale than practicing physicians and medical students. Higher scores on intolerance to clinical uncertainty were associated with higher thanatophobia scores in all groups. Scores for depressed mood, decreased sensitivity, and Machiavellianism were statistically significant predictors in some groups. Higher thanatophobia scores also predicted lower scores for ratings of self-esteem in caring for elderly patients. Among senior medical students, those with lower thanatophobia scores tended to enter primary care residencies. Health professional educators may find this scale helpful both in pinpointing sources of caregivers' angst and useful in counseling students in management of terminally ill persons.

The purpose of this study is to examine the independent and joint influences of a patient's mode of acquisition of illness (blood transfusion vs. multiple sexual partners), attributions of responsibility (self-blame vs. chance blame), and sexual orientation (homosexual vs. heterosexual) on female and male medical students' attitudes toward and willingness to treat a patient who is HIV infected. One hundred nineteen 1st through internship-year medical students were randomly assigned to read and respond to case vignettes. Greater consistency between attribution of blame and mode of acquisition was related to more positive perceptions. Furthermore, the patient's sexual orientation influenced the providers' willingness to offer treatment, particularly for male medical students. Implications concerning health practices and medical education are considered.

This study investigated students' wishes regarding the use of life-sustaining treatments (LST) in different health conditions compared with their evaluations of the wishes of elderly people, and with reports of a group of elderly people about themselves. Data were collected from two consecutive classes of first year medical students (n = 101), and a random sample of Israeli elderly aged 70+ (n = 987) who responded to fixed-choice questions regarding their will to live and wishes for three kinds of LST in a number of hypothetical illness conditions. The students were also asked to assess elderly's wishes. Students ranked the will to live of elderly persons significantly lower than their own. The elderly ranked their will to live significantly lower than did the students, but higher than the students assumed about them, indicating that although the will to live is weaker among older people, it is stronger than young persons believe. With regard to the use of LST, students believe that old people want less LST than themselves, but the elderly want even less LST than assumed by the students. The best predictors of students' wishes for themselves were fear of dying and religiosity. Fear of dying, the students' self-esteem and religiosity were the best predictors of their evaluations of the elderly's wishes. The results indicate that both the elderly and the students have a relatively strong will to live, but this desire is dependent on quality of life. The implications of this study for medical education are discussed. Key words - life-sustaining treatments, will to live, medical students, elderly, doctor-patient relations, medical education