MEDICAL EDUCATION Medical Student Self-Efficacy and Attitudes toward Homeless Patients

Perhaps it is the culture of many medical schools that encourages students to specialize in more “prestigious ” and lucrative areas of medicine rather than pursue careers of service to indigent or homeless populations [1]. The frustrations of working in indigent health care often catalyze discouragement for continuing in such settings and worsen attitudes toward this population during the course of medical education [1-4]. These findings accord with reports that students become less humanitarian, more cynical, and more focused on career and practice goals during their training [5]. We believed that introducing students to care for homeless patients in a supervised experience in the Houston Outreach Medicine Education & Social Services (HOMES) Clinic would help reverse their negative attitudes toward homeless patients. There are indications that adverse caregiver attitudes and a lack of understanding contribute to reduced access to and quality of care for the homeless [6-9]. These counterproductive qualities most likely stem from training that did not adequately prepare students and physicians to manage their own reactions to this population