Abstract
BackgroundFibromyalgia syndrome (FMS) is a long-term condition that affects between 1 and 5% of the general population and lies within the spectrum of medically unexplained symptoms (MUS). FMS can be difficult to diagnose and is usually done so as a diagnosis of exclusion. There is continuing debate regarding its legitimacy excluding other causes of symptoms. It is known that the diagnosis and management of MUS, including FMS, receives little attention in medical curricula and attitudes towards patients with FMS amongst medical professionals and trainees can be negative. The purpose of this study was to investigate how attitudes and perspectives of undergraduate medical students towards FMS are acquired during their training.MethodsQualitative interviews with 21 medical students were conducted to explore their views on FMS, encounters with patients with FMS, and where learning about FMS occurs. Participants were recruited from two English medical schools and the study was approved by two University Ethics committees. Interviews were digitally recorded with consent and data analysed thematically, using principles of constant comparison.ResultsThe data were organised within three themes: i) FMS is a complex, poorly understood condition; ii) multiple sources for learning about FMS; and iii) consequences of negative attitudes for patients with FMS.ConclusionUndergraduate medical students have limited understanding of, and are sceptical over the existence of FMS. These attitudes are influenced by the ‘hidden curriculum’ and witnessing attitudes and actions of their clinical teachers. Students interpret a lack of formal curriculum teaching around FMS to mean that it is not serious and hence a low priority. Encountering a patient, friend or family member with FMS can increase knowledge and lead to altered perceptions of the condition.Teaching and learning about FMS needs to be consistent to improve knowledge and attitudes of clinicians. Undergraduate students should be exposed to patients with FMS so that they better understand patients with FMS.
Highlights
Fibromyalgia syndrome (FMS) is a long-term condition that affects between 1 and 5% of the general population and lies within the spectrum of medically unexplained symptoms (MUS)
Fibromyalgia syndrome (FMS) is a chronic condition first described in the 1970s [1]
The data were organised within three themes: i) FMS is a poorly understood, complex condition; ii) Multiple sources of learning; and iii) consequences of negative attitudes for patients with FMS
Summary
Fibromyalgia syndrome (FMS) is a long-term condition that affects between 1 and 5% of the general population and lies within the spectrum of medically unexplained symptoms (MUS). Diagnostic criteria describes fibromyalgia in terms of four areas of clinical features: chronic widespread pain (CWP), sleep disturbance, fatigue and bilateral tender points around the body [2]. FMS affects between 1 and 5% of the general population [4] and lies within the spectrum of ‘Medically Unexplained Symptoms’ (MUS) conditions, where there is no underlying biomedical explanation for the symptoms. There is continuing debate regarding its legitimacy as a diagnosis [5] This may be because the diagnostic criteria may be viewed as arbitrary [6] or because there is lack of clear pathophysiological explanation [7]. One study found that up to a quarter of General Practitioners (GPs) felt that those with FMS were ‘malingerers’ [10], meaning that their impression of FMS patients is already formed prior to consultations with patients suffering from FMS
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