The impact of medical student gender on perception of gender bias and stereotype threat during the general surgery clerkship: a prospective cohort study

Objective Women remain underrepresented in many surgical specialties and leadership positions, despite gender parity among medical school graduates. Given that third-year clerkships are pivotal for career exploration, we investigated whether women who perceived greater gender bias and were more susceptible to stereotype threat reported a lower sense of belonging and worse well-being during their general surgery clerkship. Design Students were invited to participate in this prospective cohort study during clerkship orientation. Participants completed the same survey instrument during orientation and upon clerkship completion. Correlation analysis was conducted, and linear mixed models and regression models were created. Setting Virginia Tech Carilion School of Medicine (Roanoke, Virginia, USA), a tertiary care academic hospital. Participants All third-year medical students on their required six-week general surgery clerkship over an 11-month timeframe were eligible to participate, of which 48/49 students completed the survey at both timepoints. Results Perceived gender bias was negatively correlated with sense of belonging (pre: r = − 0.55, 95% CI (− 0.72, − 0.30), p < 0.0001; post: r = − 0.65, 95% CI (− 0.79, − 0.44), p < 0.0001) and well− being (pre: r = − 0.42, 95% CI (− 0.63, − 0.15), p = 0.003; post: r = − 0.40, 95% CI (− 0.62, − 0.12), p = 0.005); whereas, susceptibility to stereotype threat was less strongly correlated to both domains. Although women students reported higher perception of gender bias, the adjusted mixed-effects model demonstrated a small and imprecise gender effect (β = 0.37, 95% CI (− 0.02, 0.76), p = 0.018). Women reported increased susceptibility to stereotype threat compared to men (β = 0.82, 95% CI (0.32, 1.32), p = 0.001). Conclusions Perceived gender bias is a key correlate of medical students’ sense of belonging and well-being during the general surgery clerkship. Interventions to reduce perceptions of gender bias may promote entry and success of individuals into surgical careers.