Decline of medical student idealism in the first and second year of medical school: a survey of pre-clinical medical students at one institution.

Background: Idealism declines in medical students over the course of training, with some studies identifying the beginning of the decline in year 3 of US curricula.

Purposes: This study tested the hypothesis that a decline in medical student idealism is detectable in the first two years of medical school.

Methods: We sought to identify differences in survey responses between first-year (MS1) and second-year (MS2) medical students at the beginning (T1) and end (T2) of academic year 2010 on three proxies for idealism, including items asking about: (a) motivations for pursuing a medical career; (b) specialty choice; and (c) attitudes toward primary care.