Investigating Medical Students' Perceptions of Gender Bias in Clinical Pain Management Observations

White, Bethan and Katti, Karuna and Mirza Torabi, Shahrzad and Rapteas, Leandros (2026) Investigating Medical Students' Perceptions of Gender Bias in Clinical Pain Management Observations. Journal of Anatomy: 66 P2/30. ISSN 0021-8782

Abstract

Gender bias in pain management can impair diagnosis and treatment, often leading to the psychologisation and undertreatment of women's (cisgender and transgender) pain. While policies promote equitable care, little is known about how early-stage medical students perceive and internalise such biases. This study aimed to quantify perceptions of gender differences in pain management among first-, second- and third-year medical students, explore how biases are observed in practice, and evaluate perceived curriculum adequacy. In this mixed-methods pilot, 22 medical students completed a 17-item paired-Likert survey, six open-ended reflections, and three semi-structured interviews. Wilcoxon signed-rank tests compared mirrored female and male pain scenarios, while thematic analysis was applied to qualitative data. Students agreed that women's pain is more often attributed to psychological causes (p = 0.0078) and that women must advocate more strongly for analgesia than men (p = 0.0027). Only 14% felt prepared by the curriculum to address gender bias, while 91% called for further training. Although 55% reported confidence in identifying bias, interviews revealed that power dynamics created hesitancy in challenging clinicians. Students recognised gender disparities in pain management but felt underprepared to address them due to limited formal training. These preliminary findings suggest potential value in incorporating interactive, bias-focused education into the medical curriculum, developing tools to track bias awareness over time, and including more diverse patient scenarios in teaching. Further research is needed to explore the feasibility and impact of such measures, including the potential development of an NHS audit tool to monitor clinical gender bias. Approval was granted in March 2025 by the Department of Biomedical Science Ethics Committee, University of Birmingham (Reference Number: BMSRP_2025_EDU17).