Gender bias in medical education: Stop treating it as an inevitability

Editor - The article by Samuriwo et al1 explores an important issue in medical education: How do we reduce the influence of gender on the system through which medical students develop into clinicians? As fifth-year students, we were encouraged to see that this issue is being discussed. However, in our opinion, Samuriwo et al1 treat gender bias as a simple, inevitable problem and fail to suggest appropriate action. First, Samuriwo et al1 reduce the problem into binary categories, only briefly acknowledging the existence of transgender or gender-fluid individuals. The fight against gender bias is hindered by these outdated definitions and ideas. We also believe that exclusion of the gender-fluid definitions from academic conversations has a trickle-down effect on medical education, such that issues regarding transgender patients are often missing from our curricula, even in genitourinary medicine and sexual health where this is vitally important.2 The most alarming aspect of the conversation around gender-based discrimination in clinical education is that there is no mention of accountability. Samuriwo et al1 discuss the degree of confidence felt by students in regard to challenging or reporting discriminatory behaviour. However, there is no discussion regarding the specific process of reporting discrimination, nor any mention of the duty of the medical school in such a situation. It is well established that gender discrimination can pose a significant problem for medical students’ learning, career progression and emotional well-being.3 Though doctors, nurses and other health care professionals have a duty to maintain a discrimination-free work environment, this duty at the workplace-level is too often used to overshadow the higher-level duty of the medical school to monitor and support its students' well-being. Students are often told to report any experience of discrimination to their medical school, but rates of reporting are low, which is often attributed to perceptions of ineffectiveness.4 If we want to eliminate gender bias in medical education, we need medical schools to commit to greater action. We should promote a top-down approach, involving regular reviews of gender-specific issues within each medical school along with a robust, centralised system for reporting issues to the medical school. The medical schools in the United Kingdom need to use inclusive definitions of gender and when issues do arise, they must take greater accountability over student well-being. It is time to stop talking about this issue and start dealing with it.