MEDICAL-STUDENTS AS PATIENTS - A PILOT-STUDY OF THEIR HEALTH-CARE NEEDS, PRACTICES, AND CONCERNS

Background. The personal health experiences of medical students may co ntribute in important but previously unacknowledged ways to their well -being and education. This pilot study surveyed medical students about their health care needs, practices, insurance status, and concerns ab out seeking care. Method. A questionnaire was developed and distribute d to 151 students at the University of New Mexico School of Medicine i n 1993-94. Participant privacy was protected. Responses were compiled and analyzed using logistic regression models and odds ratios. Results . A total of 112 students responded. Most reported health care needs a nd half routinely received care at their training institution. One-thi rd had informally requested prescriptions or diagnostic tests from med ical school faculty and housestaff; one-fourth used such informal cons ultation as their ''usual'' method of obtaining care. Eighteen student s were uninsured. The students reported that they had not sought care for several reasons, and many had experienced difficulty in obtaining care. The students indicated concern about confidentiality and about t he dual role as both student and patient at the training institution. They believed that their academic standing would be jeopardized if the y developed certain health problems. When asked about hypothetical sce narios, a majority preferred to avoid the dual role of medical student -patient, When asked about scenarios in which medical student peers ex hibited suicidal depression or severe drug abuse, the students overwhe lmingly preferred not to notify the medical school administration. Sig nificant differences in responses were found with respect to gender an d training level. Conclusion. This pilot study examined the health car e needs, practices (including the use of informal consultation), insur ance status, and concerns of students at one medical school. The findi ngs highlight the students' perceptions of illness and vulnerability d uring medical school training. Constructive implications for academic medicine are discussed regarding initiatives in the areas of policy, r esearch, and the resources and structure of student health care servic es.