Indigenous students in medical education : seeding success in motivating doctors to serve underserved Indigenous communities

Purpose: Rural Australian patients continue to receive inadequate medical attention. One potential solution to this is to train Indigenous Australians to become medical doctors and return to their community to serve their people. The study aims to examine whether Indigenous medical students have a stronger intention to practice in underserved communities. Methodology: A sample of Indigenous (N = 17) and non-Indigenous students (N = 188) from a medical program in Sydney was surveyed about their medical self-concept and motivation. Confirmatory factor analysis (CFA) was conducted, group differences were tested, and correlation patterns were examined. Findings: CFA found seven distinct factors – three medical self-concepts (affective, cognitive, and cultural competence), one motivation factor, and three work-related variables – intention to serve underserved communities (intention), understanding of Indigenous health (understanding), and work-related anxiety (anxiety). Indigenous medical students were higher in cultural competence, intention, and understanding. Both the affective and cognitive components of medical self-concept were more highly correlated with intention and understanding for Indigenous students than for non-Indigenous students. Research implications: It is important to examine medical students’ self-concepts as well as their cultural characteristics and strengths that seed success in promoting service to underserved Indigenous communities. Practical implications: The findings show that Indigenous medical students tended to understand Indigenous health issues better and to be more willing to serve underserved Indigenous communities. By enhancing both the affective and cognitive components of medical self-concepts, the “home-grown” medical education program is more likely to produce medical doctors to serve underserved communities with a good understanding of Indigenous health.