Medical students’ illness‐related cognitions

Medical Education 2011: 45: 1241–1250 Context  Doctors do not follow guidance when managing their own health and illness. This behaviour may start at medical school. This study aimed to investigate whether inappropriate responses to illness are an issue for medical students and, if so, to identify the determinants of students’ responses to illness. Methods  We undertook a qualitative study using framework analysis to explore the views of medical students at two UK medical schools. Results  Eight focus groups carried out with 35 medical students identified four main themes in students’ cognitions about their intended behaviour: not using usual patient pathways; informal consultation; self‐treatment, and keeping going when ill. The reasons or assumptions underlying these beliefs referred to: time and resources, including wider issues such as responsibility to colleagues; stigma and attitudes of others including regulatory bodies; beliefs about themselves in terms of taking on the patient role and issues relating to coping and self‐sufficiency; the behaviour and attitudes of peers; patient safety considerations; patients’ views about sick doctors; barriers to accessing care; the ease of self‐care, and uncertainty about ability to self‐care. Conclusions  Many different factors related to medical students’ beliefs about illness. Conflicts occur among student needs to be seen as competent and dedicated to medicine, to protect personal privacy, to maintain convenience, and to seek care appropriately in order to be fair on colleagues and protect the public. These conflicts were complicated by perceptions of the system, peers and doctors as unsupportive of ill health except by facilitating informal access to care. Beliefs underlying intentions are similar between doctors and medical students, but further research is needed to fully determine how and when these beliefs are formed.