Third- and Fourth-Year Medical Students' Changing Views of Family Medicine

The effect of third-year family medicine clerkships on shaping contemporary US students' knowledge and attitudes toward family medicine is not well understood. The objectives of this study were to assess third-year medical students' attitudes toward family medicine before and after a family medicine clerkship, to assess students' interest in a family medicine career before and after the clerkship, and to compare these findings to the same students' attitudes toward family medicine in the fourth year.

An anonymous questionnaire assessing attitudes toward family medicine was offered to 150 medical students in the class of 2011 at a geographically dispersed, community-based US medical school. Students were offered the questionnaire during their third year, on the first and last days of the required 8-week family medicine clerkship, and midway through the fourth year.

At least 92 students completed participation at each time point (response rate 61%). Twenty-seven percent of students initially unlikely to choose family medicine as a career became interested after the clerkship. Ninety percent of those interested in family medicine maintained their interest. Attitudes toward lifestyle and compensation, family medicine's role in research, and family physician expertise significantly improved after the clerkship. However, gains in some of these areas regressed in the fourth year.

The clerkship improves students' attitudes toward, and interest in, family medicine. However, students' favorable attitudes deteriorate when they are no longer exposed to family medicine instruction. Educational practices focused on fourth-year students may be needed to support and maintain student interest in family medicine.