Gender differences in Medical Students experience of Obstetrics and
Gynaecology clinical education, in countries where Islam is the state
religion compared to ‘Westernised’ countries: A systematic review.
Abstract
Competence in intimate examinations is expected of all graduating
doctors, regardless of gender. These examinations are challenging to
teach and learn, with medico-legal and ethical issues surrounding
patient consent. Religion, culture, and societal expectations may also
impact this. Objectives: to determine if male medical students in
countries where Islam is the state religion are disadvantaged during
their O&G clinical education. A systematic literature review was
performed by searching ‘MEDLIINE’, ‘Web of science’, and ‘Science
Direct’. References were manually searched. Studies relating to gender
differences in undergraduate O&G clinical education were included.
Studies outside of the years 2000-2020 were excluded. Data was extracted
and critically appraised. A narrative synthesis method was employed.
Nine out of ten studies reported that female students performed more
vaginal exams than males during their O&G placement – four studies
reported statistical significance, with three being from countries where
Islam is the state religion. Five studies reported that females
performed more speculum examinations. Six studies reported significance
in the number of males who had experienced declined consent to perform
intimate examinations. The paper from Malaysia reported a figure higher
(93.3%) than any from ‘Westernised’ countries. Four studies reported
significance regarding the perception of gender bias from male students.
Gender bias is present in O&G undergraduate clinical education. In
addition to lower participation and higher refusal rates, male students
also perceive gender bias. Religion and culture put male medical
students training in countries where Islam is the state religion, at an
additional disadvantage to those in ‘Westernised’ countries.