An important but stressful part of their future work: medical students' attitudes to palliative care throughout their course.

Context: Palliative care (PC) education for medical students is important. Knowledge concerning drugs and services can be readily taught, and skills of communicating with terminally ill patients and their families are increasingly being addressed. Developing positive attitudes toward caring for patients near the end of life is more challenging.

Objectives: To examine medical students' attitudes toward PC in each year of their course, investigate changes in these attitudes over time during their course, and identify gender differences in attitudes and attitudinal change.

Methods: Questionnaires administered to four cohorts of preclinical core science and clinical medical students at the University of Cambridge Medical School from 2007 to 2010, with annual longitudinal follow-up in subsequent years; 1027 participants in total.

Results: Students started their medical course with broadly positive attitudes toward PC, which largely persisted into the final years. During the core science component, some attitudes became more negative, whereas during the clinical component, some attitudes became more positive. Over the whole course, there was evidence of increasingly positive attitudes. No significant effect of gender on attitudes or attitudinal change was found. Although statistically significant, all these changes were small.

Conclusion: Medical students' attitudes toward their future role in caring for people with PC needs were broadly positive. Core science was associated with increasingly negative attitudes and clinical studies with increasingly positive attitudes. For teaching faculty, the challenge remains to address negative and foster positive attitudes toward PC during medical school.