[Perception of undergraduate medical students of the educational environment at Instituto Mexicano del Seguro Social]

To ascertain the perception of third and fourth year medical students and interns (fifth year) about the educational environment during the clinical education phase and during the internship at Instituto Mexicano del Seguro Social (IMSS).

A questionnaire with 120 items was developed to evaluate whether IMSS educational environment encourages reflection and criticism among medical students and interns. The highest possible score of the questionnaire was 240 points. A t test was used to compare the score of the students who were classified according to the term in which they were enrolled. 1997 medical students and 1075 interns from 46 IMSS clinical settings answered the previously validated questionnaire.

Seventy percent of the students considered that the educational environment was not very favorable for reflection and criticism; 19% perceived it as favorable and 11% as unfavorable. The median score of third and fourth year medical students, was 134.9 (range 80-193; p = 0.27), interns' score was 130.4 (range 80-208; p = 0.001). The perception of the medical students in clinical settings other than Mexico City was less unfavourable (median 132.8; range 63.5-208); p = 0.003).

apparently, the occupational environment influences the educational environments where the courses take place. As long as the students advance in their courses and get involved in clinical practice, their perception of the educational environment becomes unfavorable.