Medical student, physician, and public perceptions of health care disparities.

OBJECTIVES This study investigates first- and fourth-year medical students' perceptions about health care disparities and compares their perceptions with those of physicians and the public. METHODS We conducted an analysis of a national survey of medical students that included questions addressing unfair treatment of patients in the health care system based on insurance status, money, English language ability, and race/ethnicity. Results were compared with previously collected data from surveys of physicians and the public. The study also analyzed students' opinions about workforce diversity and cultural competence curricula. RESULTS Medical students were generally more likely than physicians and the public to perceive unfair treatment of patients. First-year medical students were more likely than fourth-year students, and fourth-year students more likely than physicians, to perceive unfair treatment. Minority medical students and physicians were generally more likely than their white counterparts to perceive unfair treatment. The majority of medical students desired more exposure to disparity issues and endorsed medical workforce diversity. CONCLUSIONS Perceptions of unfair treatment in the health care system differ among medical students, physicians, and the public, as well as among racial/ethnic groups. Minority students and physicians are more likely to perceive greater levels of unfairness. Our results suggest that perceptions of unfair treatment may decline during the process of acculturation to the medical profession. Interventions to reduce health care disparities must address the process of medical education and training.