BACKGROUND: We evaluated the effect of international electives on the attitudes of preclinical and clinical-year medical students with respect to serving underserved multicultural populations.

METHODS: A self-assessment instrument was used to measure attitudes of 146 students before and after participating in international electives. The same attitudinal items were also analyzed at two time intervals for 18 students who completed international electives as preclinical students and 76 class cohorts who did not.

RESULTS: Analyses show that the effect of international experiences is different for preclinical students and clinical students. For both groups, however, these experiences can develop and support perceptions and values conducive to serving underserved multicultural populations. These include reported increases in cultural competence and important personal attributes like idealism and enthusiasm. In addition, these experiences can heighten clarity about career roles, including those involving underserved multicultural patients.

CONCLUSIONS: This study provides support for the hypothesis that international electives develop attributes that could benefit underserved multicultural populations.