Objectives: To study the frequency of negative comments (badmouthing) made by teaching hospital specialists about metropolitan and rural general practitioners (GPs) and by GPs about hospital specialists and the impact of these comments on medical students' intended career choice. In this study badmouthing is defined as unwarranted, negative, denigrating, even sarcastic comments made by doctors about other doctors.
Methods: A retrospective questionnaire survey of 170 5th and 6th year medical students from The University of Western Australia conducted in 1997. The questionnaire was a modified version of one developed by medical educators at the University of Washington School of Medicine, using both ranked and open questions.
Results: Overall students reported either no comments or hearing balanced comment from both teaching hospital specialists and GPs. Seventy-eight percent of all students reported at least one negative comment per year about urban GPs, 50% reported a negative comment on rural GPs and 59% a negative comment by GPs about specialists in teaching hospitals. The reported impact on students, intentions to pursue any of these three disciplines was inversely proportional to the frequency of negative comments heard. Twelve percent of students reported being influenced against pursuing a future career in urban general practice, 7% against becoming a rural GP and 8% against becoming a specialist. Widespread badmouthing of rural GPs, reported in 1987, has apparently diminished with students reporting balanced and positive comment on rural GPs to be five times more common than negative comment.
Conclusion: A low level of badmouthing by all medical disciplines is an unattractive part of the learning milieu of medical students. In this study it had an influence on the current career choices of 21% of participating students.