Medical student attitudes toward the doctor-patient relationship

Med Educ. 2002 Jun;36(6):568-74. doi: 10.1046/j.1365-2923.2002.01233.x.


Context: Medical educators have emphasized the importance of teaching patient-centred care.

Objectives: To describe and quantify the attitudes of medical students towards patient-centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient-centred attitudes.

Methods: We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient-Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor-patient relationship. Total PPOS scores can range from patient-centred (egalitarian, whole person oriented) to disease- or doctor-centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate coursework, family medical background and specialty choice were collected from the fourth year class.

Results: A total of 510 students (76%) completed data collection. Female gender (P < 0.001) and earlier year of medical school (P = 0.03) were significantly associated with patient-centred attitudes. Among fourth year students (n = 89), characteristics associated with more patient-centred attitudes included female gender, European-American ethnicity, and primary-care career choice (P < 0.05 for each comparison).

Conclusion: Despite emphasis on the need for curricula that foster patient-centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor-centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient-centred care in the current medical environment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centred care.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Attitude to Health*
  • Curriculum
  • Delivery of Health Care / standards*
  • Education, Medical, Undergraduate / methods*
  • Ethnic Groups
  • Female
  • Humans
  • Male
  • Patient Satisfaction
  • Patient-Centered Care
  • Physician-Patient Relations*
  • Sex
  • Students, Medical / psychology*