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Gender in medicine - an issue for women only? A survey of physician teachers' gender attitudes.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
2003 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 2, no 1, 10- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: During the last decades research has disclosed gender differences and gender bias in different fields of academic and clinical medicine. Consequently, a gender perspective has been asked for in medical curricula and medical education. However, in reports about implementation attempts, difficulties and reluctance have been described. Since teachers are key persons when introducing new issues we surveyed physician teachers' attitudes towards the importance of gender in professional relations. We also analyzed if gender of the physician is related to these attitudes. METHOD: Questionnaires were sent to all 468 senior physicians (29 % women), at the clinical departments and in family medicine, engaged in educating medical students at a Swedish university. They were asked to rate, on five visual analogue scales, the importance of physician and patient gender in consultation, of physician and student gender in clinical tutoring, and of physician gender in other professional encounters. Differences between women and men were estimated by chi-2 tests and multivariate logistic regression analyses. RESULTS: The response rate was 65 %. The physicians rated gender more important in consultation than in clinical tutoring. There were significant differences between women and men in all investigated areas also when adjusting for speciality, age, academic degree and years in the profession. A higher proportion of women than men assessed gender as important in professional relationships. Those who assessed very low were all men while both men and women were represented among those with high ratings. CONCLUSIONS: To implement a gender perspective in medical education it is necessary that both male and female teachers participate and embrace gender aspects as important. To facilitate implementation and to convince those who are indifferent, this study indicates that special efforts are needed to motivate men. We suggest that men with an interest in gender issues should be involved in this work. Further research is needed to find out how such male-oriented endeavours should be outlined.

Place, publisher, year, edition, pages
2003. Vol. 2, no 1, 10- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-6113DOI: 10.1186/1475-9276-2-10PubMedID: 14613502OAI: diva2:145781
Available from: 2007-12-06 Created: 2007-12-06 Last updated: 2016-09-05Bibliographically approved
In thesis
1. “I am solely a professional – neutral and genderless”: on gender bias and gender awareness in the medical profession
Open this publication in new window or tab >>“I am solely a professional – neutral and genderless”: on gender bias and gender awareness in the medical profession
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: During the last decades research has reported seemingly unjustified differences between how women and men are perceived as patients, medical students and physicians. Most studies have been performed outside Scandinavia. The overall aim of this thesis is to illustrate, analyse and discuss aspects of gender bias and gender awareness in clinical medicine, medical research and medical education, all in a Swedish setting.

Material and methods: Physicians’ ways of reasoning and reflecting on different professional arenas were investigated from a gender perspective in three cross-sectional studies: A. Written answers from a national examination for 289 Swedish interns where the examinees were allocated to suggest management of a common health problem - irritable bowel syndrome - in either a male or a female paper-patient with identical case descriptions. B. Assessments from 682 physicians, in structured assessment forms, of the scientific quality of two fictive research abstracts - one with a quantitative and one with a qualitative design – where authorship was assigned to either a woman or a man. C. Answers from 303 physician teachers to a questionnaire where they, on scales, assessed the importance of gender in different professional relationships and also gave open-ended comments.

Most analyses were quantitative, using chi2-tests and multivariate logistic regression as statistical methods. Differences were discussed in relation to gender theory. Qualitative method, by way of open and selective coding, was used to explore the open-ended answers in the questionnaire and to create codes from the written answers in the national exam.

Results: A. There were differences in outcome for male and female cases in history taking and in proposed diagnoses, investigations and treatment, e.g. more questions about and tests for alcohol were suggested for men and more tests for thyroid function for women. Both men and women physicians contributed to the gender bias but showed different patterns. B. The quantitative abstract was judged the same regardless of the gender of the assessor or author. The qualitative abstract was not ranked as scientific as the quantitative, but as more accurate, trustworthy, relevant and interesting with a female author especially by women assessors. C. Men physicians, especially in the surgical group, expressed low awareness of gender compared to women physicians. The qualitative analysis rendered a picture of how the physicians perceive ‘gender’, problems they connect with gender and their attitudes to gender issues. Some important concepts identified were ‘inequity’, ‘difference’, ‘delicate situations’, and ‘resistance’. To get an overview and better understanding of various expressions of gender bias, a theoretical model was developed, on the basis of the findings in the qualitative analysis. The main findings of the thesis are discussed in relation to this model where equity/inequity and sameness/difference are important points of departure.

Conclusions: The findings of gendered outcome in the national exam call attention to ‘knowledge-mediated gender bias’, a phenomenon implying that once knowledge of gender differences in a condition has been established this might cause gender biased assessments of individual patients in the clinical situation. Gender appears to affect scientific evaluations. This has implications for situations where research is assessed and interpreted: in medical tutoring, research guidance, peer reviewing, and in forming evaluation committees for research funding. Physician teachers seem little aware of gender as an area of competence and knowledge and tend to connect gender issues with women. Depending on how ‘difference’ and ‘equity’ are apprehended various forms of resistance to gender emerge, each with plausible bias risks. Educational programmes for faculty members, encouraging continuous reflections on gender attitudes and supporting male participation, are suggested. Besides providing a more comprehensive understanding of patients and their health problems, increased gender awareness among physicians might improve the working climate and help reduce the gendered division of labour in the medical profession.

71 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 907
Gender, gender bias, gender awareness, physicians, clinical decision-making, research evaluation, medical education, medical teachers, tutors, division of labour
Research subject
hälso- och sjukvårdsforskning
urn:nbn:se:umu:diva-300 (URN)91-7305-701-0 (ISBN)
External cooperation:
Public defence
2004-09-17, Rosa salen, 9B, 13:00
Available from: 2004-09-07 Created: 2004-09-07 Last updated: 2016-09-05Bibliographically approved

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Risberg, GunillaJohansson, EvaWestman, GöranHamberg, Katarina
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