Changing first-year medical students' attitudes toward primary care

With the passing of the Patient Protection and Affordable Care Act, an additional 34 million people will gain access to health care. Combined with population growth and aging adults, expanded insurance coverage will dramatically increase the demand for primary care services. To encourage medical students to pursue primary care, medical schools are integrating courses that will expose students to primary care medicine early in their education. We used a descriptive, cross-sectional study design to evaluate the impact of a week-long intensive course in primary care on first-year medical students' attitudes toward primary care. We developed a 25-item survey to assess medical students' knowledge, perception, and attitudes about primary care; the survey was administered before and after the course. A total of 125 first-year medical students (mean age=23.7 ± 2.9 years, 52.4% female, 75.8% Non-Hispanic white, 11.2% rural) completed the pre-course survey, and 117 completed the post-course survey. We observed positive improvements in attitudes toward primary care in 20 of the 25 survey questions (with effect sizes ranging from 0.16--0.33). Further, students stated that the course improved their understanding of the scope of primary care and emphasized the importance and complexity of primary care medicine. A week-long intensive course in primary care can influence medical students' attitudes toward primary care; however, the long-term impact on students' decision to pursue primary care is not known and needs to be evaluated. These findings provide empirical support for the integration of primary care courses into medical school curricula.