Posted on November 18, 2008

Non-White Med Students Reject Therapies Associated With Their Culture

BJS, Science Blog, November 17, 2008

Non-white medical students are more likely to embrace orthodox medicine and reject therapies traditionally associated with their cultures. That is one finding from an international study that measures the attitudes of medical students toward complementary and alternative medicine (CAM). While seemingly counter-intuitive, white students view CAM more favorably than their non-white counterparts, the study authors say.

CAM is the common, collective term that describes non-orthodox therapies considered not intrinsic to the politically dominant health system of a particular society or culture.

Despite the growing popularity of CAM, many medical schools do not include CAM teachings within basic medical education. So researchers at four medical schools (Peninsula, UK; Birmingham, UK; Georgetown, USA; and Auckland, NZ) conducted two surveys to measure the attitudes of medical students toward CAM during their first and fourth year of medical training in schools that offer some CAM education either at the undergraduate or graduate level. The study is published online in Medical Teacher.

“The first study we conducted with first-year medical students indicated that overall, students wanted more information about CAM in their curriculum,” said Hakima Amri, PhD, director of the Complementary and Alternative Medicine Program at Georgetown University Medical Center, the only science-based CAM Master’s program at an academic institution in the United States. Amri is a co-investigator and the lead author of the US component of the study. “Our follow-up study measured attitude changes about CAM during medical training. We didn’t observe a significant change in overall attitude between the first and fourth year, but we did spot some other interesting trends.”

Amri says in the first study, U.S. medical students wanted more courses about CAM than students in Hong Kong, for example. (The Hong Kong school was not included in the 2nd survey of fourth year students.) The second study continued to support that trend with the least interest in CAM measured in Asian and black students.


A total of 604 first-year medical students at six schools completed the questionnaire. Only students who indicated willingness to complete the second questionnaire were contacted to participate in the second survey three years later. A total of 154 out of 487 (31.6 percent) of fourth year students at four schools completed the questionnaire.


[Editor’s Note: “Medical students’ attitudes to complementary and alternative medicine: Further validation of the IMAQ and findings from an international longitudinal study,” byCharlotte Rees, Andy Wearn, Ian Dennis, Hakima Amri, Sheila Greenfield (Med Teach. 2008 Sep 29; :1-8 18825561 (P,S,G,E,B)), has not yet been posted on-line. Check at this page to see when it is posted.]

Office of Postgraduate Medical Education (OPME), Faculty of Medicine, University of Sydney, Sydney, Australia.

Background: Current research mainly employs cross-sectional designs to examine changes in medical students’ attitudes towards complementary and alternative medicine (CAM). Aims: This paper reports the findings of a longitudinal study to further validate the Integrative Medicine Attitude Questionnaire (IMAQ) and examine changes in medical students’ attitudes over 3 years. Methods: A total of 154 medical students from four schools in three countries completed a modified version of the IMAQ during their first (T1) and fourth year (T2). Results: We established the validity of a three-factor model for the IMAQ: (1) attitudes towards holism; (2) attitudes towards the effectiveness of CAM therapies, and (3) attitudes towards introspection and the doctor-patient relationship. We found that IMAQ factor scores did not differ significantly from T1 to T2, emphasizing the relative stability in attitudes across time. Various student characteristics were significantly associated with IMAQ factor scores at T2: age, gender, CAM use, CAM education and school; and two variables (gender and CAM use) predicted changes in medical students’ attitudes between T1 and T2. Conclusions: We urge medical educators to continue exploring medical students’ attitude changes towards CAM and we provide examples of what further research is needed.