Attitudes of Medical Students

This is the authors' abstract. We don't add key points for this paper.

To the Editor:—In their interesting paper,1 Green and her colleagues suggest that the geriatric rotation per se had little effect on the medical students' attitudes towards the elderly. This seems hardly surprising since the geriatric rotation comprised merely four days (one day at weekly intervals for a month) of exposure to a geriatric service. The details of this service are not given but it seems that this meant teaching based in a nursing home. Experience in the University of Liverpool (U.K.) was similar when only five consecutive days in a geriatric service (acute and rehabilitation wards) comprised the geriatric clerkship. However, when this was extended to five weeks and included a two-week project undertaken in elderly patients' homes, then not only did attitudes apparently change, but behaviors did! Applications for rotations as interns and residents followed, and we had the satisfaction of producing internists and family doctors who had a reasonable grounding in geriatric medicine. The decisive change came with the increase in undergraduate experience of a full range of geriatric medical practice. There has been a comparable change elsewhere in the United Kingdom.2 Unfortunately, the “hidden curriculum”3 often projects a negative view of the elderly, hence we continue to produce doctors who are frustrated by their elderly patients' inability and apparent unwillingness to have interesting diseases that rapidly resolve.4