Prospective study of how students' humanism and psychosocial beliefs relate to specialty matching

To determine whether students who match to different specialties are different in their humanistic behaviors and attitudes about the psychosocial aspects of medicine.

From May 1992 to February 1995 data were collected from 405 students at the Baylor College of Medicine who participated in a required six-week family medicine clerkship. Two instruments were used to collect data: the Humanism Scale and the Physician Belief Scale. The students' humanism was rated by standardized patients (SPs) during the clerkship's objective structured clinical examination; the SPs used an abbreviated scale, consisting of eight items rated on a seven-point scale. The Physician Belief Scale, consisting of 32 items rated on a five-point scale, measures beliefs about the psychosocial aspects of patient care; it was completed by each student prior to the beginning of the clerkship. Specialty match data were based on National Resident Matching Program results at graduation. For statistical analysis, specialties were divided into four groups: primary care, medical, surgical, and support.

The students who matched to primary care specialties had significantly higher mean humanism scores than did the students who matched to support specialties. Also, the students who matched to primary care specialties had significantly higher belief-scale scores than did the students who matched to surgery or support specialties.

The differences between the students matching to various specialties found in this study were only partly consistent with the differences found in another study of resident physicians in the same specialties. The postgraduate residency experience may thus be an important factor accounting for this difference between students and physicians.