E2 ModeratePreliminaryPEM not requiredCross-SectionalPeer-reviewedMachine draft
Standard · 3 min
Do you think it's a disease? a survey of medical students.
Erueti, Chrissy, Glasziou, Paul, Mar, Chris Del et al. · BMC medical education · 2012 · DOI
Quick Summary
This study asked medical students whether various health conditions should be classified as a 'disease' or not. Interestingly, when the same condition was given a more medical-sounding name (like 'myalgic encephalomyelitis') versus a simpler name (like 'chronic fatigue syndrome'), students were more likely to call it a disease. This suggests that the words doctors use to describe an illness can influence how seriously it is viewed, even when describing the exact same condition.
Why It Matters
For ME/CFS patients, this research demonstrates that how a condition is named and framed linguistically influences whether healthcare providers conceptualize it as a legitimate disease. Since the study directly compared 'myalgic encephalomyelitis' with 'chronic fatigue syndrome'—showing the medical terminology was more likely to be classified as disease—it highlights a potential barrier to patient recognition and appropriate clinical care. Understanding these linguistic and conceptual biases in medical education is crucial for improving how emerging and contested illnesses are understood and managed.
Observed Findings
80% of students agreed that 16 conditions (e.g., diabetes, tuberculosis) were diseases, and 80% agreed that 4 conditions (e.g., baldness, menopause) were not diseases.
The remaining 16 conditions showed contested classification with only 21-79% student agreement, including obesity, infertility, hay fever, alcoholism, and restless leg syndrome.
Myalgic encephalomyelitis was classified as disease significantly more often than chronic fatigue syndrome, despite being synonymous conditions.
Hypertension was classified as disease significantly more often than 'high blood pressure' by medical students.
Some objectively serious conditions (fractured skull, heat stroke) were unexpectedly excluded from disease classification by a substantial proportion of students.
Inferred Conclusions
Medical terminology influences how conditions are conceptualized; more formal medical labels increase the likelihood of disease classification compared to lay terminology for identical conditions.
There remains fundamental disagreement among future clinicians about what constitutes a 'disease,' suggesting insufficient attention to disease conceptualization in medical education.
The framing and naming of conditions significantly impacts clinical recognition and could influence the quality of care patients receive for contested or emerging diagnoses.
Remaining Questions
What This Study Does Not Prove
This study does not establish whether medical students' disease classifications actually reflect objective biological reality or correlate with clinical outcomes. It also does not prove that terminology alone causes mismanagement; students' underlying knowledge gaps, training deficits, or prior attitudes may independently influence both terminology preference and disease classification. The cross-sectional design cannot determine causality—whether medical terminology drives disease classification or whether conditions perceived as diseases receive more medical terminology.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Does the difference in disease classification between terminology variants (e.g., myalgic encephalomyelitis vs. chronic fatigue syndrome) persist into clinical practice and affect patient management?
What underlying educational or psychological factors drive students' classification decisions—is it familiarity with terminology, exposure to clinical examples, or conceptual understanding?
How do these classification patterns change after graduation and clinical experience, and do they influence diagnostic practices or treatment decisions?
What outcomes or objective biological markers should guide disease classification for contested conditions like ME/CFS?