Medical Students' Interest in Serving Medically Underserved Populations: A Follow-Up Study.

Introduction: Despite exposure to vulnerable populations, many medical students report feeling inadequately prepared to advocate for these communities. Therefore, it is critical to understand what drives students to engage with the underserved. In this study, we build on prior work to examine whether student characteristics and self-reported engagement experiences are associated with medical students' motivation to work with medically underserved populations, and how these factors evolve. Methods: This cross-sectional study used multiple instruments to assess medical students at UT Southwestern Medical School across three time points in medical school. Surveys included the Medical Student Attitudes Toward the Underserved (MSATU), Interpersonal Reactivity Index (IRI), and Interprofessional Attitudes Survey (IPAS), along with demographic data, academic performance, service-learning activities, and future career plans. We categorized specialties into primary care versus non-primary care. We used bivariate correlations and group comparisons to examine differences in MSATU, empathy, leadership, teamwork, and community-centeredness. Results: Most participants were female (61.2%) and interested in non-primary care specialties (61.8%). Interest in primary care was positively associated with higher MSATU total scores, Empathy, IPAS: teamwork, and IPAS: community, while leadership was not associated with primary care interest. MSATU total scores were positively correlated with empathy, IPAS: teamwork, IPAS: community, and leadership. Conclusions: As demonstrated in our prior work, the MSATU, IRI, and IPAS showed strong associations among medical students, likely reflecting shared protective factors. In this expanded cohort, the association between empathy, community-centeredness, and interest in primary care may be explained by the specialty's emphasis on community engagement and longitudinal patient relationships.