Exploring Gender Perspectives in Medical Education: A Latent Semantic Analysis of Israeli First-Year Medical Students’ Reflections (Preprint)

Gender is increasingly recognized as a crucial determinant of health and healthcare delivery. Integrating gender-sensitive content into medical education is essential for cultivating socially responsive, culturally competent, and clinically effective future physicians. However, limited research has examined how medical students conceptualize gender in clinical contexts, particularly through their own reflective narratives. This study aimed to explore the thematic landscape of gender-related perceptions among first-year medical students in Israel following a mandatory course in gender medicine. Using Latent Semantic Analysis (LSA), we investigated how students reflect on gendered dimensions of healthcare and how these reflections vary by gender and ethnicity. First-year medical students enrolled in the four-year path of medicine in Israel participated in a compulsory gender medicine course and were invited to submit anonymous written reflections. A total of 83 students (62.7% female, 37.3% male; 81.9% Jewish, 18.1% Arab) submitted responses, which were preprocessed and analyzed using LSA. Texts were lemmatized and vectorized to construct a term-document matrix, followed by singular value decomposition for dimensionality reduction. Ten latent topics were extracted, and thematic labels were assigned through an inductive, consensus-based coding procedure. Subgroup analyses were conducted by gender and ethnicity. LSA identified 10 distinct topics explaining 56.6% of total variance in the overall sample. The most dominant theme was gendered patient-doctor interactions (eigenvalue = 121.188; 28.1% variance; 527 terms; 75 documents), followed by gender-specific diseases and health concerns (5.7%), and cultural and religious influences on healthcare (4.3%). Female students' reflections introduced three unique themes: gendered help-seeking and familial roles (2.8%), gender and health education (2.5%), and gendered communication and advocacy (2.2%). Male students uniquely discussed perceived gender bias in clinical/research settings (3.8%) and legal/ethical dimensions of reproductive healthcare (3.3%). Among Jewish students, additional themes included population-level framing of gendered conditions (3.7%) and gendered youth expectations (2.1%). Arabic students contributed culturally specific themes such as modesty and cultural norms (8.6%), paternal authority and structural discrimination (6.3%), and reproductive vulnerability (3.6%). Thematic patterns in student reflections suggest that gender medicine curricula are effective in prompting critical engagement with diverse gendered realities in clinical care. The emergence of culturally grounded and gender-specific themes highlights the importance of tailoring educational interventions to reflect student diversity.