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

Background  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. Setting  A London medical school. Results  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%). Conclusion  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.