Medical Students' Views and Knowledge of the Affordable Care Act: A Survey of Eight U.S. Medical Schools

J Gen Intern Med. 2015 Jul;30(7):1018-24. doi: 10.1007/s11606-015-3267-9. Epub 2015 Mar 10.

Abstract

Background: It is not known whether medical students support the Affordable Care Act (ACA) or possess the knowledge or will to engage in its implementation as part of their professional obligations.

Objective: To characterize medical students' views and knowledge of the ACA and to assess correlates of these views.

Design: Cross-sectional email survey.

Participants: All 5,340 medical students enrolled at eight geographically diverse U.S. medical schools (overall response rate 52% [2,761/5,340]).

Main measures: Level of agreement with four questions regarding views of the ACA and responses to nine knowledge-based questions.

Key results: The majority of respondents indicated an understanding of (75.3%) and support for (62.8%) the ACA and a professional obligation to assist with its implementation (56.1%). The mean knowledge score from nine knowledge-based questions was 6.9 ± 1.3. Students anticipating a surgical specialty or procedural specialty compared to those anticipating a medical specialty were less likely to support the legislation (OR = 0.6 [0.4-0.7], OR = 0.4 [0.3-0.6], respectively), less likely to indicate a professional obligation to implement the ACA (OR = 0.7 [0.6-0.9], OR = 0.7 [0.5-0.96], respectively), and more likely to have negative expectations (OR = 1.9 [1.5-2.6], OR = 2.3 [1.6-3.5], respectively). Moderates, liberals, and those with an above-average knowledge score were more likely to indicate support for the ACA (OR = 5.7 [4.1-7.9], OR = 35.1 [25.4-48.5], OR = 1.7 [1.4-2.1], respectively) and a professional obligation toward its implementation (OR = 1.9 [1.4-2.5], OR = 4.7 [3.6-6.0], OR = 1.2 [1.02-1.5], respectively).

Conclusions: The majority of students in our sample support the ACA. Support was highest among students who anticipate a medical specialty, self-identify as political moderates or liberals, and have an above-average knowledge score. Support of the ACA by future physicians suggests that they are willing to engage with health care reform measures that increase access to care.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Female
  • Health Care Reform
  • Humans
  • Male
  • Medicine
  • Patient Protection and Affordable Care Act*
  • Professional Competence / statistics & numerical data*
  • Schools, Medical
  • Students, Medical / psychology*
  • United States
  • Young Adult