MEDICAL-STUDENTS PERCEPTIONS OF UNETHICAL CONDUCT AT ONE MEDICAL-SCHOOL

Purpose. To assess medical students' perceptions of the ethical enviro nment across four years of medical school. Method. In the spring of 19 96, the authors distributed a questionnaire to all four classes at the Wake Forest University School of Medicine. The students provided demo graphic information and information about their exposures to or partic ipation in unethical situations. Results were analyzed using multiple analysis of variance, univariate analysis of variance, Pearson correla tion, and cross-tabulations. Results. The response rate was 71%. The s tudents reported that exposures to unethical behavior started early an d continued to increase with each year in school. For example, 35% of the first-year students reported observing unethical conduct by reside nts or attending physicians. This percentage rose to 90% of the fourth -year students. The authors found no significant relationship between demographic variables other than the year in school and the ethical di lemma variables. Conclusion. Medical students face perceived ethical d ilemmas beginning as early as the first year of medical school. Thus e thics instruction must; begin in the freshman year. In addition, there must be changes to the environment in which clinical education is con ducted to enhance the positive enculturation of students into the medi cal profession.