*Purpose: Physicians often do not refer appropriate candidates for organ donation and the reasons may be rooted in personal beliefs about transplantation. Students come to Medical School with pre-existing beliefs about ethically complicated topics that may affect their future medical decisions. We examined baseline knowledge and attitudes about organ donation in a cohort of medical students with the aim of examining how religion or ethnicity might interact with knowledge and attitudes towards organ donation.

*Methods: A previously validated questionnaire, was distributed to 190 Second Year Medical Students at a required session, prior to their Neuroscience unit. Students returned the survey anonymously to a box. The survey included 12 questions addressing specific knowledge about organ donation as well as attitudes and comfort with knowledge, using a 5 point Likert scale.

*Results: 132 students returned the survey. There were 64 women (48.5%) and 66 men (50%). Racial breakdown was 8% African American, 31% Asian, 44% Caucasian, 8% Hispanic and 4% did not answer. Religious affiliation included 22% Atheist, 14% Catholic, 3% Hindu, 15% Jewish, 7% Muslim, 8% Protestant, 22% no affiliation, 8% other or did not answer. 46% had not signed an organ donor card and 57% had not discussed organ donation with their families. By Chi Squared analysis students who identified as Atheist (22/27) were more likely to sign the card than Catholic (6/18), Jewish (8/19), Hindu (1/4) or Muslim (1/9) students (p<0.005). 6 students disapproved of organ donation, all were Hindu, Muslim, Jewish or unaffiliated (p<0.005). Religious affiliation influenced whether the students would donate the organs or a child or relative, with Atheists and unaffiliated most likely and all others undecided or unlikely (p=0.003). There was no difference in exposure to education regarding transplantation or brain death. Of the 28 students who felt unprepared to deal with organ donation, 5 were Catholic, 6 were Jewish, 7 unaffiliated and 1 each Protestant or Muslim (p=0.043). There was no interaction of gender or ethnicity with religious affiliation or the answers to the above questions.

*Conclusions: Organ donation is a difficult topic, which involves the intersection of belief and medical science. Religious beliefs may play a role in reluctance of physicians to refer patients for organ donation. We found a strong relationship between religious affiliation and attitudes toward organ donation in a cohort of Medical Students at the end of the pre-clinical course. It is suggested that education regarding organ donation during the pre-clinical years should involve campus religious figures as well as transplant professionals, as most religions do not interdict organ donation and personal interpretation of religious doctrine may prevent students from referring patients as organ donors when they become physicians.

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