The influence of patient gender on medical students' care: Evaluation during an objective structured clinical examination

Abstract

ObjectivesTo assess whether men and women are evaluated and treated differently by medical students. MethodsWe evaluated patient care provided by 110 fifth-year medical students during an objective structured clinical examination (OSCE), using two clinical cases with standardized patients (SPs): generalized anxiety disorder (GAD) and ascending aortic dissection (AAD). Half of the students encountered male and half female SPs. Except for gender, the cases were identical. We compared diagnosis and treatment of male vs female SPs. ResultsStudents diagnosed GAD more often in female SPs than in male SPs (diagnosis completed, partially completed, and not completed in 47%, 16% and 36% respectively vs. 22%, 20%, and 58% for male SPs, p = 0.02). The nature of symptoms was better described for male SPs. For AAD, the emergency was more frequently identified and the examination of femoral pulses better performed in female SPs. ConclusionMedical students have a gender bias when evaluating patients with GAD and AAD. Practice implicationThe observed gender bias in the evaluation of patients, likely leads to differences in treatment between male and female patients (i.e. under-recognition of anxiety in men). Medical schools should implement gender-sensitive medical education initiatives to improve inclusive patient care.