Perspective: medical students' perceptions of the poor: what impact can medical education have?

Full Abstract

There is currently little knowledge or understanding of medical students' knowledge and attitudes toward the poor. Teaching hospitals bring students face-to-face with poor and uninsured patients on a regular basis. However, an overview of the research available suggests that this contact does not result in students' greater understanding and empathy for the plight of the poor and may, in fact, lead to an erosion of positive attitudes toward the poor. A basic understanding of justice suggests that as the poor are disproportionately the subjects of medical training, this population should enjoy a proportionate benefit for this service. Furthermore, medicine's social contract with the public is often thought to include an ideal of service to the underserved and a duty to help educate the general public regarding the health needs of our nation. In their discussion, the authors situate medical students' attitudes toward the poor within larger cultural perspectives, including attitudes toward the poor and attributions for poverty. They provide three suggestions for improving trainees' knowledge of and attitudes toward the poor-namely, increasing the socioeconomic diversity of students, promoting empathy through curricular efforts, and focusing more directly on role modeling. The authors argue that service learning, especially efforts that include gaining detailed knowledge of a particular person or persons, coupled with critical reflection, presents a very promising direction toward achieving these goals. Finally, they posit an agenda for future educational research that might contribute to the increased efficacy of medical education in this important formative domain.

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Author information

Author/s: Wear, Delese (D); Kuczewski, Mark G (MG);

Affiliation: Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, USA.

Journal and publication information

Publication Type: Journal Article; Review

Journal: Academic medicine : journal of the Association of American Medical Colleges (Acad Med), published in United States. (Language: eng)

Reference: 2008-Jul; vol 83 (issue 7) : pp 639-45

Dates: Created 2008/06/26; Completed 2008/07/22;

PMID: 18580079, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Attitude of Health Personnel
Education, Medical, Graduate
Education, Medical, Undergraduate
Empathy
Health Knowledge, Attitudes, Practice
Humans
Poverty - psychology

Poverty - psychology
Prejudice
Social Class
Social Perception
Socioeconomic Factors
Students, Medical - psychology
United States

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