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An Institutional Evaluation of Medical Student Interest in Care for the Underserved

David Anthony, Paul George, Marina MacNamara, Shmuel P Reis, Julie Scott Taylor


Background and Objectives: The United States of America is currently experiencing a shortage of physicians caring for underserved populations, perpetuated in part by increasingly negative attitudes during medical school towards working with these populations. The objective of this study is to provide a baseline assessment of the attitudes of all medical students at our institution towards caring for the underserved that will then guide the development, implementation and evaluation of a multi-pronged, 5-year intervention.

Methods: For this mixed methods, cross-sectional study, we administered the validated Medical Student Attitudes Towards the Underserved (MSATU) survey to all 4 classes at one medical school within one academic year. Statistical analysis was performed through bivariate analyses followed by multivariate regression analyses for significant bivariate associations. Three focus groups involving a total of 23 second-, third- and fourth-year medical students provided qualitative data.

Results: The survey response rate was 72% (n= 280/395). Higher MSATU scores were significantly associated with an interest in a primary care career and with prior work with the medically underserved. We found no significant association between score and year of training. Focus group participants cited: (1) exposure to underserved populations and (2) clinician role models as major factors affecting their attitudes towards the underserved.

Conclusions: In our cross-sectional analysis, student attitudes towards underserved populations did not decline over the span of 4 medical school classes. Ongoing research will attempt to understand more deeply the relationship between medical student characteristics and the decision to care for underserved patients after graduation.


Attitude of health personnel, person-centered healthcare, undergraduate medical education, vulnerable populations

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HRSA grant #D56HP20688.



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