Abstract
BackgroundResearch shows that medical education is characterized by unequal conditions for women and men, but there is a lack of qualitative studies investigating the social processes that enable and maintain gender inequalities that include both male and female students. In this focus group study, we therefore explored male as well as female medical students’ experiences of the gender climate – i.e., how beliefs, values, and norms about gender were communicated – during clinical training and how the students dealt with these experiences.MethodsFocus group interviews were conducted with 24 medical students (nine men) at Umeå University, Sweden. The interviews were structured around personal experiences in clinical training where the participants perceived that gender had mattered. Data were analysed using qualitative content analysis.ResultsThe students described gender-stereotyped expectations, discriminatory treatment, compliments, comments, and demeaning jargon. Female students gave more personal and varied examples than the men. The students’ ways of handling their experiences were marked by efforts to fit in, for example, by adapting their appearance and partaking in the prevailing jargon. They felt dependent on supervisors and staff, and due to fear of repercussions they kept silent and avoided unpleasant situations and people rather than challenging humiliating jargon or supervisors who were behaving badly.ConclusionsEveryday communication of gender beliefs combined with students’ adaptation to stereotyped expectations and discrimination came across as fundamental features through which unequal conditions for male and female students are reproduced and maintained in the clinic. Because they are in a dependent position, it is often difficult for students to challenge problematic gender attitudes. The main responsibility for improvements, therefore, lies with medical school leadership who need to provide students and supervisors with knowledge about gendered processes, discrimination, and sexism and to organize reflection groups about the gender climate in order to improve students’ opportunities to discuss their experiences, and hopefully find ways to protest and actively demand change.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0803-1) contains supplementary material, which is available to authorized users.
Highlights
Research shows that medical education is characterized by unequal conditions for women and men, but there is a lack of qualitative studies investigating the social processes that enable and maintain gender inequalities that include both male and female students
Conditions during studies and clinical training still differ according to gender, and studies show that many female students report difficulties in terms of limited possibilities to receive supervision or to participate in practical training [4,5,6]
The importance of gender awareness in medical education has received attention in recent years [13,14,15,16], and many medical schools have included education about gender in their curricula [17,18,19]. Such gender education has often been met with scepticism and resistance, and researchers in the field attribute this resistance to attitudes and values among students as well as teachers [16, 20]. This shows that formal curricular content must be viewed in the context of what is sometimes labelled the “hidden curriculum” [21], referring to the fact that many critical determinants of medical education do not operate within the formal curriculum, but through attitudes, values, and behaviours communicated in everyday interactions and clinical encounters
Summary
Research shows that medical education is characterized by unequal conditions for women and men, but there is a lack of qualitative studies investigating the social processes that enable and maintain gender inequalities that include both male and female students In this focus group study, we explored male as well as female medical students’ experiences of the gender climate – i.e., how beliefs, values, and norms about gender were communicated – during clinical training and how the students dealt with these experiences. Such gender education has often been met with scepticism and resistance, and researchers in the field attribute this resistance to attitudes and values among students as well as teachers [16, 20] This shows that formal curricular content must be viewed in the context of what is sometimes labelled the “hidden curriculum” [21], referring to the fact that many critical determinants of medical education do not operate within the formal curriculum, but through attitudes, values, and behaviours communicated in everyday interactions and clinical encounters. These informal experiences influence students’ socialization and have a powerful impact on their professional identity formation [22]
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