Medical Students' Perceptions of Gender and Ethnic Bias in Pain Management : A Mixed Methods Study

Sandhu, Seema and Katti, Karuna and Mirza Torabi, Shahrzad and Rapteas, Leandros (2026) Medical Students' Perceptions of Gender and Ethnic Bias in Pain Management : A Mixed Methods Study. Journal of Anatomy: 67 P2/31. ISSN 0021-8782

Abstract

Disparities in pain management based on gender and ethnic background have been widely documented; however, limited research has explored how medical students perceive these biases in relation to their own demographic characteristics. This cross-sectional mixed-methods pilot study hypothesised that medical students, particularly those from marginalised backgrounds, would recognise both gender and ethnic bias in clinical pain management. Twenty-two medical students from years one to three of the University of Birmingham completed a bespoke questionnaire combining Likert-scale items, open-ended questions, and follow-up interviews. Quantitative data suggested that while students recognised gender and ethnic bias separately, they struggled to identify their intersection. A significant finding was that students perceived female patients as needing to advocate more strongly for pain relief compared to males (p = 0.0036), though no significant differences were observed in treatment outcomes. Thematic analysis of qualitative responses suggested that although students expressed confidence in detecting bias, they reported infrequent observation of such incidents in practice, and no clear pattern was found linking student gender or ethnicity with bias recognition. This may indicate that systemic biases are internalised regardless of the students' own demographic background. These initial findings suggest value in expanding this research to a larger cohort and support further investigation into how structural and educational changes might better equip students to recognise and address intersectional bias. Approval was granted in March 2025 by the Department of Biomedical Science Ethics Committee, University of Birmingham (Reference Number: BMSRP_2025_EDU17).