Policy implications of physicians' attitudes towards being examined by medical students.

Abstract

Background: Physicians who become patients-especially those involved in teaching-hold a dual perspective that may influence their comfort with medical student involvement in their care. Understanding these attitudes is essential for shaping medical education policies related to consent, patient assignment, and professional boundaries. This study explored Israeli family physicians' willingness to be examined by medical students and examined implications for clinical teaching policy.

Methods: A cross-sectional survey was conducted among Israeli family physicians during June-July 2024. A total of 149 participants completed a structured questionnaire assessing their comfort with students observing, taking medical histories, and performing physical, intimate, and invasive examinations. Data were analyzed using descriptive statistics and chi-square tests to compare subgroups by gender, age, and teaching status.

Results: Among the 149 respondents (mean age 47.2 years; 65.1% female), 92.6% were comfortable with students observing non-intimate exams, but only 29.5% agreed to student presence during intimate exams. Comfort increased slightly if the student was of the same gender (48.3%), but overall acceptance remained low. Female physicians were significantly less willing than males to undergo physical exams by students (63.5% vs. 88.2%; p = 0.006) and were more uncomfortable with male students performing intimate exams (48% vs. 28.1%; p = 0.014). Physicians aged ≤ 45 were less willing to student observation than those aged ≥ 46 (61.0% vs. 42.3%; p = 0.033). Only 16.8% agreed to allow students to perform invasive procedures. Interestingly, teaching physicians were significantly less likely than non-teachers to agree to student presence during intimate exams (29.7% vs. 51.6%; p = 0.018).

Conclusions: While student involvement in non-invasive care is widely accepted, substantial discomfort persists with intimate and invasive scenarios-particularly among female and teaching physicians. These findings raise ethical and educational concerns. Institutions should consider: (1) Allowing physician-patients to opt out of student involvement without stigma; (2) Implementing real-time, standardized informed consent for all patients, including physicians; (3) Creating clear guidelines on teacher-student dynamics in clinical care.