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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.
  • Rachael Wahid,
  • Jacqueline Woodman,
  • Robert Hooper
Rachael Wahid
University of Warwick Warwick Medical School

Corresponding Author:[email protected]

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Jacqueline Woodman
University Hospital Coventry
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Robert Hooper
University of Warwick Warwick Medical School
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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.