Journal of Regional Medical Campuses

What is really important to this generation of medical students? A look back into a college pathways program

Alexis Head, BS

University of Louisville School of Medicine Trover Campus

https://orcid.org/0009-0000-2726-1049

Emily Bolinger, BS

University of Louisville School of Medicine Trover Campus

Collin McGlone, BS

University of Louisville School of Medicine Trover Campus

https://orcid.org/0009-0002-9414-4576

William J. Crump, MD

Univeristy of Louisville School of Medicine Trover Campus at Baptist Health Madisonville

https://orcid.org/0009-0009-7942-4757

DOI: https://doi.org/10.24926/jrmc.v8i3.7035

Keywords: Gen-Z, pre-med, summer program, survey

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Abstract

Background: Surveys of college student attitudes and life plans conducted prior to the COVID-19 pandemic have been attributed to the “Generation Z” effect. Few scientifically valid studies have addressed these changes after the pandemic, though many opinion pieces have expressed medical educators perceive that almost everything has changed. This longitudinal study reports an annual measure of college students’ opinions during a medical school pathway program at a regional campus. The Treatment Options Opinion Survey (TOOS) included 5 medical and 6 social items and has been used each year since 2005.

Methods: The TOOS was administered on the first and last days of the 3–4 week summer College Rural Scholar (CRS) program. The survey began with the prompt: “Indicate your opinion concerning the importance of understanding the following items in choosing the best treatment option for your patient.” Each of the 11 TOOS items used a 5-point response scale (1 = strongly disagree to 5 = strongly agree). The study included 87 pre-medical CRS participants from the 2016–2019 summers (pre-COVID, termed the “previous cohort”) and 2022–2025 (termed the “COVID-era cohort”). Distributions and means were calculated and analyzed using the Kruskal-Wallis one-way analysis of variance. Statistical significance was defined as p < .05.

Results: The change after the program was largely in the expected direction, but there were no statistically significant differences in importance of traditional medical items, which were consistently ranked as high importance before and after the program in both student cohorts. Of the six social items, most showed a significant increase in measured importance after the program by both COVID- era (2022-2025) and previous (years 2016-2019) student cohorts with two exceptions.
“Understanding how ready the patient is to make changes” was much more important to the COVID- era student cohort. In contrast, there was no statistical increase in this item’s importance for the previous cohort from pre- to post-program. Similarly, “understanding the health beliefs held by the patient” was rated significantly more important by the COVID-era student cohort, with no significant change observed in the earlier group. COVID

Conclusion: Medical educators have recognized that almost nothing is the same since the 2020 pandemic. The fundamental aspects of good doctoring remain, but Gen Z learners—shaped by the world-shattering events of their formative years—carry these experiences into their early professional identity development. This unique longitudinal study of a homogeneous pre-medical population suggests that these students naturally seek a more egalitarian patient-physician relationship and place greater emphasis on the patient's beliefs and readiness for change. As these students enter medical school, it is important for medical educators to appreciate that this shift has already occurred, while awaiting further studies in more diverse settings.

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Author Biographies

Alexis Head, BS, University of Louisville School of Medicine Trover Campus

Alexis Head, BS, M3 Medical Student, University of Louisville School of Medicine Trover Campus

Emily Bolinger, BS, University of Louisville School of Medicine Trover Campus

Emily Bolinger, BS, M3 Medical Student, University of Louisville School of Medicine Trover Campus

Collin McGlone, BS, University of Louisville School of Medicine Trover Campus

Collin McGlone, BS, M3 Medical Student, University of Louisville School of Medicine Trover Campus