Health Advocacy and Training Perceptions: a Comparison of Medical Student Opinions

The American Medical Association considers health advocacy to be a core aspect of a physician's responsibility, which has sparked medical schools to institutionalize training. However, there is little information regarding student perspectives on advocacy education.

To evaluate medical student opinions on advocacy education and to determine similarities and differences across classes.

In this qualitative study, four focus groups were conducted with five to eight students from each medical school class. Students were randomly selected from rosters and received an email to participate. Sessions were audiotaped and transcribed, and demographic data was obtained. Investigators reviewed transcripts independently and identified important items in each transcript then consolidated common themes into groups. These themes were integrated into concept map representations.

Of those contacted, 25 (16%) students chose to participate in focus group sessions. All participants who responded to questionnaires (n = 24) identified advocacy in medicine as very important. Definitions of advocacy varied among students and classes. Common themes in all focus groups included feeling overwhelmed by advocacy due to lack of time, lack of perceived prioritization in medical education, feelings of imposter syndrome, and inability to align individual views with healthcare systems. Another common theme was frustration that students learned of advocacy through didactic sessions rather than engagement in advocacy work.

All participating students identified advocacy as an important aspect of medicine, yet students felt inadequately prepared to participate in advocacy work. This reveals an opportunity to improve upon the formal education needed to engage in advocacy.