Where students go when they are ill: How medical students access health care

Department of Primary Care and Population Sciences, Royal Free and University College Medical Schools, London, UK.
Medical Education (Impact Factor: 3.2). 07/2005; 39(6):588-93. DOI: 10.1111/j.1365-2929.2005.02175.x
Source: PubMed


Doctors have high levels of self-treatment, investigation and referral, but little is known about how medical students seek health care. Methods We carried out a questionnaire survey of Year 2 and 4 students, exploring their health-seeking behaviour and attitudes to self-care.
A London medical school.
The response rate was 80%. Nearly all students (99%) were registered with a general practitioner (GP). A total of 43% had informally consulted doctors who were friends or relatives in the previous 12 months (61% of those with a doctor as a family member had informally consulted, and 33% of those without a doctor as a family member had informally consulted; P = 0.001). In all, 13% of Year 4 students and 2.2% of Year 2 students had received a prescription from a friend (P = 0.007). Almost a quarter (22%) of Year 4 and 1.3% of Year 2 students reported having directly contacted a specialist (P = 0.01). A third (32%) (43% Year 4, 1.3% Year 2; P = 0.006) of those referred in the previous 12 months had contacted the consultant directly. In all, 9.2% (0% Year 2, 20% Year 4; P = 0.001) had initiated their own investigations, and 25% (47% Year 4, 7% Year 2; P = 0.001) had been examined by a colleague. Students agreed that it was appropriate for doctors to self-investigate (52%), self-refer (59.1%) and self-prescribe (39.2%).
Medical students appear to bypass their GPs and initiate investigations, referrals or treatment. This is associated with increased clinical access or access through family members. Self-management of illness is learnt early on in students' careers and is increased with availability and increasing clinical access.

Download full-text


Available from: Richard Meakin, Aug 11, 2014
  • Source
    • "It is very important to detect psychiatric distress at an early phase so that treatment in the form of counseling, behavior therapy, cognitive therapy and even pharmacotherapy can be considered for those affected. Therefore, psychiatric morbidity such as depression and anxiety can be prevented among our medical students and young doctors (19). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Considering the association between medical school dropout and psychiatric distress, we aimed to assess the prevalence of psychiatric distress among medical students at Dubai Medical College. Methods: One hundred and three medical students were chosen randomly and were assessed by the General Health Questionnaire (GHQ). Results: The mean age for the students was 18.85 year (Minimum: 17, Maximum: 22), and 90.3% were between 18 and 20 years old. The mean of GHQ score was 16.46. Of the participants, 47 (45.6%) were found to be in normal range (GHQ mean < 16). A total of 33 (32.1%) of the students reported evidence of psychiatric distress. Only 23 (22.3%) were found to have severe psychiatric distress. Conclusions: Early detection of psychiatric distress is important to prevent psychiatric morbidity and its unwanted effects on medical students and young doctors. Our results reveals that although a low percentage of Dubai Medical College students reported a significant level of psychiatric distress, however, it should not be underestimated, and actions should be taken to encourage Dubai Medical College students to get help from for psychiatric services for their emotional problems. The risk factors as well as the protective factors must be identified in nation-wide studies to promote mental health of medical students.
    Full-text · Article · Feb 2012
  • Source
    • "Further, medical students have been suggested to be reluctant to seek help and (as is also true for medical professionals [13]) tend to by-pass the "regular" health-care system or avoid formal consultations [14,15]. We have only found one comparative study of students, where both psychology students and medical students reported worries about consulting a doctor for psychological problems, with regard to possible future professional dealings with that person. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Stress and distress among medical students are thoroughly studied and presumed to be particularly high, but comparative studies including other student groups are rare. A web-based survey was distributed to 500 medical students and 500 business students. We compared levels of study stress (HESI), burnout (OLBI), alcohol habits (AUDIT) and depression (MDI), and analysed their relationship with self-assessed mental health problems by logistic regression, with respect to gender. Medical students' response rate was 81.6% and that of business students 69.4%. Business students scored higher on several study stress factors and on disengagement. Depression (OR 0.61, CI95 0.37;0.98) and harmful alcohol use (OR 0.55, CI95 0.37; 0.75) were both less common among medical students. However, harmful alcohol use was highly prevalent among male students in both groups (medical students 28.0%, business students 35.4%), and among female business students (25.0%). Mental health problems in need of treatment were equally common in both groups; 22.1% and 19.3%, respectively, and was associated with female sex (OR 2.01, CI95 1.32;3.04), exhaustion (OR 2.56, CI95 1.60;4.10), lower commitment to studies (OR 1.95, CI95 1.09;3.51) and financial concerns (OR 1.81 CI95 1.18;2.80) Medical students may not be more stressed than other high achieving student populations. The more cohesive structure of medical school and a higher awareness of a healthy lifestyle may be beneficial factors.
    Full-text · Article · Nov 2011 · BMC Medical Education
  • Source
    • "To deal with the second point; our outputs compare favourably with other research training programmes, such as primary care masters degrees (Calvert and Britten, 1998) and schemes for other novice researchers (Lee and Saunders, 2004). Some of our students' projects have had real impact when published in high-impact journals (Greenhalgh et al., 2004; Seyan et al., 2004; Hooper et al., 2005) and have generated high citation indices (Snowden et al., 2001). From a departmental perspective, as has been noted by others, considerable faculty resources are needed to support novice researchers to undertake projects and to write for publication (Stefani et al., 1997; McManus et al., 1999; Thomas and Albert, 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim: To describe the research project component of the BSc in Primary Health Care and to discuss the issues faced by students and faculty in attempting to complete a student-led research project. Background: Medical schools increasingly expect medical students to undertake research as part of intercalated BSc’s or in self-selected study modules. This research has historically been laboratory based, ‘piggybacking’ onto existing projects. Projects initiated by students themselves and studies in primary care or community settings are more unusual. Methods: A qualitative study, based on interviews with students and examiners, triangulated with data from the peer review process and personal observations on the running of the course. Setting: A London medical school, running an intercalated BSc in Primary Health Care. Findings: We interviewed 24 of 26 students and two external examiners during the interview period of the study. Students successfully undertook research, from initial question through to publication. Overall, 90 dissertations were completed since 1997, of which half used a qualitative methodology (45/90). Ten projects have subsequently been published; there were also 16 conference presentations and 6 research letters. Themes from the interview data include: the students’ strong sense of project ownership, the difficulties of being a novice researcher, the difficulties posed by the research governance hurdles, the beneficial and for some students adverse impact (stress and coping with unsuccessful projects) and finally, the impact on their careers. Conclusion: Students gain considerably from this learning process, not only by undertaking their own research, but they also gain in terms of acquisition of transferable skills such as critical appraisal and improved self-directedness. Project completion and publication rates suggest that programmes developing undergraduate initiated research projects can be as successful as those for other novice researchers. The student-led project is a fragile endeavour, but currently is sustainable.
    Full-text · Article · Jan 2008 · Primary Health Care Research & Development
Show more