Sex and Gender Integration in Medical Education Since a 2016 National Survey: How Far have We Come?

<title>Abstract</title> <p> <bold>Background</bold> : Medical research over the past 30 years has shown the significant impact sex and gender has on patient care and health outcomes. However, this research evidence has not been broadly integrated into medical education or translated to clinical experiences. A 2016 national survey of medical students showed that 42% could not identify the inclusion of sex and gender specific medicine (SGBM) in their medical school curricula, and 26.9% were unsure ² . Since then, the NIH policy on sex as a biological variable in research has changed the landscape of SGBM ³ . We examine the impact on undergraduate medical education (UME). <bold>Methods</bold> : Similar to the 2016 study, we recruited a convenience sample of US medical students from national medical student organizations to complete a survey about their UME curriculum. Our assessment focused on SGBM attitudes and awareness, curricular exposure, and content knowledge. We employed student-t tests, one-way ANOVAs, and Pearson chi-squares in our analysis. <bold>Results</bold> : The majority of respondents agreed that sex and gender medicine (SGBM) improves patient management (96.5%; vs. 96.0 % in 2016), and should be included in medical school curricula (95.7%; vs. 94.2 % in 2016). Moreover, 4.9% agreed SGBM is the same as women’s health, vs. 2.1% in 2016. Students’ perception that the majority of medical knowledge is based on data obtained from males increased (88.4% in 2025 vs. 63.2% in 2016). Regarding inclusion of an identified SGBM curriculum at their medical school, students were “not sure” at 45.1% (M1), 40.5% (M2), 26.6% (M3), and 20.5% (M4), vs. 40.8, 25.1, 19.1, and 20.3% from M1 to M4 years, respectively in 2016 ² . Knowledge of evidence-based sex and gender differences within health topics increased with training years (significant for presenting symptoms in depression, myocardial infarction, coronary artery disease plaque patterns, osteoporosis risk factors, domestic violence victims, smoking cessation, narcotic addiction, and sexual dysfunction). <bold>Conclusions</bold> : Students continued to highly value SGBM, but there has been little improvement in knowledge over the past 10 years in UME. Misconceptions about many topics persist. This data underscores the importance of incorporating SGBM throughout UME curricula. <bold>Trial registration:</bold> This was not a clinical trial. The study was reviewed and deemed exempt by the University of South Carolina School of Medicine IRB. </p>