Perceptions of medical malpractice and medical malpractice reform among first- and fourth-year medical students.

Objectives: Comparison of first- and fourth-year medical student perceptions of the U.S. medical malpractice system and their disposition toward reform, and examination of the relationship between school year and other potential correlates of these perceptions.

Methods: Data derived from 109 students at Brown Medical School who responded to a 2006 web-based survey of attitudes and background characteristics. We report student perceptions stratified by medical school year. We use Mann-Whitney U and chi2 tests to examine the correlates of perceptions and linear regression to examine these in a multivariate context.

Results: There were no significant differences in the dispositions of first- and fourth-year students toward the current system (p> or =0.05). However, fourth-year students were more likely to favor screening panels for malpractice cases (82.2% vs. 70.4%) and capping pain and suffering damages (68.9% vs. 55.2%) (both p<0.05). Multivariate results reveal greater concern about malpractice among students intending to specialize in high-risk areas (both p<0.001). Bivariate results reveal greater concern among students with lawyer relatives (p<0.05).

Conclusions: First- and fourth-year students had overwhelmingly negative perceptions of the medical malpractice system. This implies attitudes toward malpractice are formed before medical school, with intended specialty and other background characteristics more negatively influencing students' views.