MEDICAL STUDENT ATTITUDES TOWARD THE DOCTOR-PATIENT RELATIONSHIP

Objectives To describe and quantify the attitudes of medical students towards patient-centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient-centred attitudes. Methods We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient-Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor- patient relationship. Total PPOS scores can range from patient-centred (egalitarian, whole person oriented) to disease- or doctor-centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate course-work, family medical background and specialty choice were collected from the fourth year class. Results A total of 510 students (76%) completed data collection. Female gender (P < 0AE001) and earlier year of medical school (P = 0AE03) were significantly associated with patient-centred attitudes. Among fourth year students (n = 89), characteristics associ-ated with more patient-centred attitudes included female gender, European-American ethnicity, and pri-mary-care career choice (P < 0AE05 for each compar-ison). Conclusion Despite emphasis on the need for curricula that foster patient-centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor-centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient-centred care in the current medical envi-ronment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centred care.