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Does medical students’ gender affect their clinical learning of gynaecological examination? A retrospective cohort study
  1. Thomas Wallbridge1,
  2. Angela Holden2,
  3. Aled Picton3,
  4. Janesh Gupta4
  1. 1A&E, Worcestershire Royal Hospital, Worcester, UK
  2. 2Sandwell General Hospital, Sandwell, UK
  3. 3Institute of Clinical Sciences, University of Birmingham Medical School, Birmingham, UK
  4. 4Institute of Metabolism and Systems Research, Birmingham Women’s Foundation NHS Trust, Birmingham, UK
  1. Correspondence to Dr Thomas Wallbridge, Worcester Royal Hospital, Worcester WR5 1DD, UK; thomas.wallbridge{at}nhs.net

Abstract

Introduction Medical graduates should be competent in gynaecological examination as well as associated skills including speculum use and swabbing. Male and female medical students may have different opportunities to practise these skills in clinical environments, potentially impacting on confidence and competence. This study explores this further via reviewing students’ learning experience in genitourinary medicine (GUM) and obstetrics and gynaecology (O&G) clinics.

Methods Cross-sectional study of 759 year 4 and year 5 University of Birmingham medical students via an online questionnaire. This explored degree of participation, impact of gender and self-reported confidence.

Results Overall response rate was 31% (233/759). Students of either gender who observed an examination being performed by a clinician were more likely to perform the same examination. Female students reported more opportunities to practise gynaecological examination and associated skills. Female students were more likely to be granted consent to perform speculum examinations, vaginal swabbing and vaginal bimanual examinations. Sixty-five per cent of male students felt that their gender affected their learning experience with female patients. Despite this, there was no significant difference in self-reported confidence level in performing gynaecological examinations between genders at the end of placement.

Conclusion The majority of male students perceived that their gender impacted their clinical experience in O&G and GUM. Self-reported confidence levels were unaffected, which could reflect varying approaches to competence between genders. The link between observing examinations and subsequent opportunities to practise is key. This could demonstrate students developing rapport and trust with patients, and clinicians’ roles as gatekeepers.

  • medical education
  • gynaecological examination
  • gender
  • obstetrics and gynaecology
  • genitourinary medicine

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Footnotes

  • Contributors TW designed the study and questionnaire; collected and analysed the data; wrote the methods, results, discussion and conclusion;and is responsible for the overall write-up. AH was heavily involved in study design; data collection and writing the discussion and results section. AP was responsible for assisting the redrafting and rewriting process as well as editing the overall paper. JG was a supervisor and provided guidance. The manuscript has been seen and approved by all authors who have contributed significantly to satisfy the authorship criteria.

  • Funding The University of Birmingham Medical School funded the online hosting of the survey for the conduct of this study.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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