1. The Effect of Inter-Disciplinary “Bad-Mouthing” on Medical Student Specialty Selection
David R. Norris MD, Martha A. Dempsey MD, Thais B. Tonore MD and Jeanann L. Suggs Ph.D
University of Mississippi Medical Center  Department of Family Medicine  Jackson, MS
Introduction
Teaching medical students appropriate professional behavior is a difficult task at best. Role-modeling is a key component of this process: preceptors must not only teach professionalism, they must live it.1 With a looming shortage of primary care physicians, it is becoming increasingly important to encourage medical students to consider family medicine and other primary care specialties.
Medical bad-mouthing has been previously implicated as a deterrent to specialty selection in 12-21% of students.2,3 Bad-mouthing has been defined as “unwarranted, negative, denigrating, even sarcastic comments made by doctors about other doctors.”3 Primary care specialists, in particular family physicians, are amongst the most maligned specialties in some studies.4 Negative themes cited as frequently heard by students include that family physicians are not as smart as other physicians, the breadth of the material is too difficult to master, and that family physicians will be put out of business by physician extenders such as physician assistants and nurse practioners.5
Studies have shown that medical students find this behavior unprofessional and have proposed several possible solutions to the problem, including increasing awareness, highlighting the interdisciplinary natural of medicine and evaluating professionalism.6
A review of the literature, reveals no studies conducted to date that have sought to evaluate the effectiveness of any of these proposed solutions.
Methods
Surveys based upon previous studies will be administered through our Department of Institutional Research. Students will rate their perception of the frequency of inter-disciplinary bad-mouthing experienced during their required third year clerkships. These include:
Family Medicine
General Surgery
Internal Medicine
Obstetrics & Gynecology
Pediatrics
Psychiatry
Students will also estimate how often each of the above mentioned specialties were the subject of bad-mouthing. Their opinion of the effect of bad-mouthing on their specialty choice during their fourth year will also be quantified. This data will be collected over a two year time period, after which we will administer our intervention of increasing awareness of the problem to our Department of Family Medicine faculty and residents. Frequent reminders of the negative view of this behavior and its effects will also be sent via to all members of the department.
After the intervention, the survey will be re-administered for the following two academic years to determine if a significant change is present. If it is, we will then share this data with the other departments mentioned and encourage them to begin their own intervention process.
Works Cited
Kenny NP, Mann KV, MacLeod H. Role-modeling in physicians’ professional formation: Reconsidering an essential but untapped educational strategy. Acad Med. 2003;78(12):
Hunt DD, Scott C, Zhonga S, Goldstein E. Frequency and effect of negative comments on medical students’ career choices. Acad Med. 1996;71(6):665-9.
Kamien BA, Bassiri M, Kamien M. Doctors bad-mouthing each other. Does it effect medical students career choices? Australian Family Physician. 1999;28(6):576-9.
Stephens MB, Lennon C, Durning SJ, Maurer D, DeZee K. Professional bad-mouthing: who does it and how common is it? Fam Med. 2010;42(6):
Campos-Outcalt D, Senf J, Kutob R. Comments heard by US medical students about family practice. Fam Med. 2003;35(8):573-8.
Holmes D, Tumiel-Berhalter LM, Zayas LE, Watkins R. “Bashing” of medical specialties: students’ experiences and recommendations. Fam Med. 2008;40(6):