Background: Gender is an important social determinant, that influences healthcare. The lack
of gender awareness leads to gender bias and can contribute to poor patient care. Our
objectives were to assess gender sensitivity and the presence of gender stereotypes among
medical students.
Methods: A valid scale (NGAMS – Nijmegen Gender Awareness in Medicine Scale), with 3
sub scores assessing gender sensitivity (GS) and gender stereotypes toward patients (GRIP)
and doctors (GRID) (ranging from 1 to 5), was translated in French and was distributed to all
the medical students registered at the University of Lausanne in April 2017. In parallel, gender
gap in medical knowledge was assessed using a clinical case of a non-gender specific
pathology (ankle sprain) and a multiple-choice question about the main cause of mortality in
Switzerland. Mean subscales were calculated for male and female students. A linear model
with students’ sex and age was built. For the clinical vignette and multiple-choice question,
percentage of correct answers were compared between male and female using chi2 tests.
Results: In total, 396 students answered to the N-GAMS questionnaire, their mean age was
22 years old, 62.6% of them were women. GS and GRID sub-scores were not significantly
different between female and male students (GS 3.62 for women, 3.70 for men, p=0.270, GRID
2.10 for women, 2.13 for men, p= 0.758). A significant difference was found with the GRIP
subscale, with a mean score of 1.83 for women and 2.07 for men (p <0.001), which suggests
a more stereotyped opinion toward patients among male students. A trend was observed with
age, gender sensibility increased (p<0.001) and stereotypes decreased (GRIP p=0.04, GRID
p=0.02) with students getting older. The clinical case vignette and multiple-choice
questionnaire were answered by 607 students (61.2% women). Students choose the same
management for female and male clinical case. However, in the multiple-choice question
students acknowledged that cardiovascular disease was the main cause of mortality for men
in 73% of cases vs. 51.3% of women (p <0.001).
Conclusion: Medical student’s gender sensitivity seems to improve throughout the medical
curriculum and women have less stereotypes toward patient than men do. Gender bias exists
in student’s knowledge and the implementation of a gender teaching in the medical curriculum
could improve students’ knowledge, limit gender bias and improve patient care.