A comparison of attitudes of medical students in England and in South Africa towards patients with life-limiting illness.

All medical schools in the U.K. now include teaching in palliative care in the undergraduate curriculum, and this is mirrored in Europe and the U.S.A. In South Africa, however, palliative care education and provision are not widely available. An increasing number of medical and nursing staff are invited to teach palliative care in other countries. Such teaching should, however, take into account the cultural attitudes the students have towards the care of patients with a chronic or terminal illness. Nineteen statements on attitudes were constructed, and medical students in Leicester, U.K., and in Medunsa, South Africa, were invited to respond to them using a 10-point Likert scale. The questionnaire was distributed before either cohort of students had received any teaching in this area. Students in South Africa were significantly more likely to want to work in a speciality where most patients were likely to be cured (p < 0.001) and significantly less likely to believe that caring for dying patients could be rewarding (p < 0.001). South African medical students had significantly fewer positive attitudes than had their U.K. counterparts toward patients being informed of a terminal prognosis (p < 0.001). This study indicates that cultural differences between medical students may have an effect on the teaching of care for patients with life-limiting illness. This has relevance for curriculum delivery, especially when professionals are invited to teach or develop material on palliative care for other countries.