Study: Less than half of medical students understand ACA

Medical students leaning toward primary care, or those in their first year of school or who self-identify as liberal, are more likely to support and feel an obligation to implement the Affordable Care Act (ACA), according to a new survey of nearly 850 medical students in Minnesota.

The study, published as an online-first research letter in the Archives of Internal Medicine (AIM), reveals that less than half of survey respondents understand the basic concept of the ACA, and 41% have no opinion regarding support for the ACA. Only 13% indicate they do not support the legislation.

Those who grasp the concept of healthcare reform are most likely to support it, researchers note, with 72% of those who understand the ACA indicating support compared with 20% who don’t understand the ACA and indicate support.

Additionally, students who say their choice of specialty was influenced by medical school debt or future earnings are less likely to support or feel a sense of obligation to implement the ACA. Third-year students are less likely to support or feel an obligation toward implementing the ACA in comparison with first-year students.

“While future physicians believe they have a responsibility to participate in implementing the ACA, these data raise concerns that they might not possess the knowledge necessary to implement reform measures in the coming years,” the study authors note.

The study was supported by a grant from the National Center for Research Resources and the National Institutes of Health.

In a related letterpublished in the same issue of AIM, Esme Cullen writes that medical schools need to incorporate more basic health policy principles into their curricula.

“A change in health insurance policy that will affect millions of Americans’ access to care for a variety of medical problems is not included in most medical curricula even 2 years after the bill is passed,” Cullen writes.

She notes that a 2010 survey of medical school deans revealed that they offered “too little” health policy education, with only 25% requiring students to take a class on health policy.

Cullen says that although the study suggests that future physicians feel strongly about expanding access to healthcare coverage to the uninsured, the fact that so many medical students believe they don’t know much about the ACA is a “disturbing truth.”

One positive trend Cullen identifies, however, is that more students are entering primary care since the passage of the ACA (an increase of nearly 2% from 2009 to 2011)-a reversal of a 10-year trend of decline.

“This change suggests that not only does the choice to enter primary care influence the likelihood of support for the bill, but also, and most important, that the bill and its provisions may have encourage more medical students to decide on primary care training,” Cullen writes.

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