The attitudes of medical students towards homeless people: does medical school make a difference?
Article first published online: 16 SEP 2003
Volume 37, Issue 10, pages 869–872, October 2003
How to Cite
Masson, N. and Lester, H. (2003), The attitudes of medical students towards homeless people: does medical school make a difference?. Medical Education, 37: 869–872. doi: 10.1046/j.1365-2923.2003.01625.x
- Issue published online: 16 SEP 2003
- Article first published online: 16 SEP 2003
- Received 28 February 2003; editorial comments to authors 17 April 2003 and 20 June 2003; accepted for publication 1 July 2003
- medical students;
- medical education
Background Homeless people have greater health care needs than those who are housed, yet often experience difficulty in accessing health care. Evidence suggests that the attitudes of doctors can create significant barriers to health care for homeless people.
Methods A validated structured questionnaire, the Attitudes Towards the Homeless Questionnaire (ATHQ), was posted to a year group of 211 medical students 2 weeks prior to their starting at the University of Birmingham in 1997, and again during their final clinical placement 5 years later. The results were explored in more depth through semistructured interviews with the 12 students displaying the greatest degree of attitude change.
Results The response rates for the 1997 and 2002 surveys were 80% and 82%, respectively, with an overall response rate of 65% of eligible students. The mean ATHQ scores for the 2 time periods were 76·3 and 74·7 (mean difference = 1·66 ± 0·8, paired t test = 2·07, P = 0·04), indicating that attitudes had become more negative during the 5-year period. Semistructured interviews highlighted the importance of professional socialisation and clinical contact on attitude development.
Conclusion This study suggests that medical students may hold more negative attitudes towards homeless people at the end of their undergraduate course than they do at the beginning of it. Medical schools may need to address this area of health care more directly in the undergraduate curriculum if tomorrow's doctors are to treat all patients equally.