First-year medical students' perceptions of physicians' responsibilities toward the underserved: An analysis of reflective essays

Objective: To explore medical students' perceptions of their future role as physicians as it relates to personal and professional responsibilities toward the underserved. Methods: The authors conducted a qualitative content analysis of 53 first-year medical students' reflective essays focusing on the question: "Access to health care is a societal problem. Do physicians have a professional obligation to help by participating in free clinics, or otherwise doing some service-type activity? What are your personal feelings about how you might balance service to other people with personal issues like income, family, and career choice?" Results: The student essays revealed students' awareness of the distinct expertise that enables physicians to offset limited access to health care. Although the majority of respondents supported physicians' responsibility to provide uncompensated care, a minority believed that there was no such responsibility attached to being a physician. Students also recognized the competing demands physicians often encounter that conflict with personal desires for service. Conclusion: The use of reflective essays in medical school curricula seems promising, in that they elicited students' beliefs on a complex topic with direct implications for professional identity and career decisions.