Perceptions and Attitudes Toward Community Medicine Among Medical Students: A Systematic Review

Abstract

Community medicine is yet to become a popular discipline as a choice for postgraduation and career among medical students in India. Our objective is to find the proportion of students opting for community medicine as a choice for a career. We also aim to find out the perceptions and attitudes of medical students about the subject of community medicine. Our inclusion criteria encompassed studies of any design, written or translated into the English language, and published from their inception up to the last date of our search, which was 15th August 2023. Our comprehensive search covered prominent databases, including PubMed, Scopus, and Embase, as well as an extensive screening of the first 10 pages of Google Scholar and Google. The risk of bias in the studies was evaluated by using the quality assessment tools recommended by the Joanna Briggs Institute critical appraisal tool for prevalence studies. In the initial search, 2069 articles were identified, with 1109 duplicates removed. The remaining 960 articles underwent title and abstract screening, leading to the exclusion of 931 articles. After applying eligibility criteria and reviewing the full text of 29 articles, seven studies were excluded. Ultimately, 22 studies were deemed eligible for inclusion in the systematic review. Among the total of 5106 students, 1032 students expressed a willingness to choose community medicine as their career. The pooled estimate, derived through a random effects model, was 0.21, with a 95% CI of 0.14 to 0.27. Studies conducted in India revealed a willingness of 0.23 (95% CI: 0.13-0.33), whereas studies conducted outside India reported a lower proportion of 0.17 (0.14-0.24). When considering the year of study, a combined willingness of 0.02 (95% CI: 0.00-0.03) was observed among first and second-year students, contrasting with a higher proportion of 0.18 (95% CI: 0.04-0.32) among thirdyear students. Fourth-year students and interns demonstrated a willingness of 0.03 (95% CI: 0.00-0.06). The factors for disliking the subject included the perceived absence of clinical engagements, concerns about financial rewards, limited prospects for recognition and fame, etc. By actively engaging in the solution of these challenges, medical educators and policymakers can contribute to the vitalization of community medicine as a coveted and attractive specialty.