Gender-Based Discrimination Among Medical Students: A Cross-Sectional Study in Brazil

Published:November 15, 2022DOI:



      Gender-based discrimination (GBD) creates a hostile environment during medical school, affecting students' personal life and academic performance. Little is known about how GBD affects the over 204,000 medical students in Brazil. This study aims to explore the patterns of GBD experienced by medical students in Brazil.


      This is a cross-sectional study using an anonymous, Portuguese survey disseminated in June 2021 among Brazilian medical students. The survey was composed of 24 questions to collect data on GBD during medical school, formal methods for reporting GBD, and possible solutions for GBD.


      Of 953 responses, 748 (78%) were cisgender women, 194 (20%) were cisgender men, and 11 (1%) were from gender minorities. 65% (616/942) of respondents reported experiencing GBD during medical school. Women students experienced GBD more than men (77% versus 22%; P < 0.001). On comparing GBD perpetrator roles, both women (82%, 470/574) and men (64%, 27/42) reported the highest rate of GBD by faculty members. The occurrence of GBD by location differed between women and men. Only 12% (115/953) of respondents reported knowing their institution had a reporting mechanism for GBD.


      Most respondents experienced GBD during medical school. Cisgender women experienced GBD more than cisgender men. Perpetrators and location of GBD differed for men and women. Finally, an alarming majority of students did not know how to formally report GBD in their schools. It is imperative to adopt broad policy changes to diminish the rate of GBD and its a consequential burden on medical students.


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        • Kisiel M.A.
        • Kühner S.
        • Stolare K.
        • et al.
        Medical students’ self-reported gender discrimination and sexual harassment over time.
        BMC Med Educ. 2020; 20: 503
        • Rademakers J.J.D.J.M.
        • van den Muijsenbergh M.E.T.C.
        • Slappendel G.
        • Lagro-Janssen A.L.M.
        • Borleffs J.C.C.
        Sexual harassment during clinical clerkships in Dutch medical schools.
        Med Educ. 2008; 42: 452-458
        • Siller H.
        • Tauber G.
        • Komlenac N.
        • Hochleitner M.
        Gender differences and similarities in medical students’ experiences of mistreatment by various groups of perpetrators.
        BMC Med Educ. 2017; 17: 134
        • Nora L.M.
        • McLaughlin M.A.
        • Fosson S.E.
        • et al.
        Gender discrimination and sexual harassment in medical education: perspectives gained by a 14-school study.
        Acad Med. 2002; 77: 1226-1234
        • Bruce A.N.
        • Battista A.
        • Plankey M.W.
        • Johnson L.B.
        • Marshall M.B.
        Perceptions of gender-based discrimination during surgical training and practice.
        Med Educ Online. 2015; 20: 25923
        • National Academies of Sciences, Engineering, and Medicine, Policy and Global Affairs, Committee on Women in Science, Engineering, and Medicine, Committee on the Impacts of Sexual Harassment in Academia
        Benya F.F. Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine. National Academies Press (US), Washington (DC)2018
        • Salles A.
        • Milam L.
        • Cohen G.
        • Mueller C.
        The relationship between perceived gender judgment and well-being among surgical residents.
        Am J Surg. 2018; 215: 233-237
        • Henning M.A.
        • Zhou C.
        • Adams P.
        • et al.
        Workplace harassment among staff in higher education: a systematic review.
        Asia Pac Educ Rev. 2017; 18: 521-539
        • Fnais N.
        • Soobiah C.
        • Chen M.H.
        • et al.
        Harassment and discrimination in medical training: a systematic review and meta-analysis.
        Acad Med. 2014; 89: 817-827
        • Shin H.Y.
        • Lee H.A.
        The current status of gender equity in medicine in Korea: an online survey about perceived gender discrimination.
        Hum Resour Health. 2020; 18: 78
        • Yaghmour A.
        • Alesa A.
        • Anbarserry E.
        • et al.
        Challenges and obstacles faced by trainee female physicians: an integrative research on gender discrimination, stress, depression and harassment.
        Healthcare (Basel). 2021; 9: 160
        • Madeeh Hashmi A.
        • Rehman A.
        • Butt Z.
        • Awais Aftab M.
        • Shahid A.
        • Abbas Khan S.
        Gender discrimination among medical students in Pakistan: a cross sectional survey.
        Pak J Med Sci Q. 2013; 29: 449-453
        • Midik O.
        • AytuĞ KoŞan A.M.
        • Coskun O.
        • Baykan Z.
        • SÜrel Karabilgin ÖztÜrkÇÜ Ö.
        • Şenol Y.
        Gender in medical education in Turkey: the intern perspective.
        J Adv Med Educ Prof. 2020; 8: 149-157
        • Janjua M.B.
        • Inam H.
        • Martins R.S.
        • et al.
        Gender discrimination against female surgeons: a cross-sectional study in a lower-middle-income country.
        Ann West Med Surg. 2020; 57: 157-162
        • Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira
        Censo da Educação Superior: principais Resultados.
        (Available at:)
        • Eysenbach G.
        Improving the quality of web surveys: the checklist for reporting results of internet E-surveys (CHERRIES).
        J Med Internet Res. 2004; 6: e34
        • Pendleton A.A.
        • McKinley S.K.
        • Pendleton V.E.
        • et al.
        A multi-institutional study of patient-derived gender-based discrimination experienced by resident physicians.
        Am J Surg. 2021; 221: 309-314
        • de la Torre-Pérez L.
        • Oliver-Parra A.
        • Torres X.
        • Bertran M.J.
        How do we measure gender discrimination? Proposing a construct of gender discrimination through a systematic scoping review.
        Int J Equity Health. 2022; 21: 1
        • Heidari S.
        • Babor T.F.
        • De Castro P.
        • Tort S.
        • Curno M.
        Sex and Gender Equity in Research: rationale for the SAGER guidelines and recommended use.
        Res Integr Peer Rev. 2016; 1: 2
        • Censo Da Educação Superior 2020
        Instituto nacional de estudos e pesquisa educacionais Anísio Teixeira.
        2020 (Available at:)
        • World Health Organization
        Delivered by women, led by men: a gender and equity analysis of the global health and social workforce.
        World Health Organization, 2019 (Available at:) (License: CC BY-NC-SA 3.0 IGO)
        • Scheffer M.
        • Cassenote A.
        • Guerra A.
        • et al.
        Demografia Médica no Brasil 2020.
        CFM, São Paulo: FMUSP2020
        • Rrustemi I.
        • Locatelli I.
        • Schwarz J.
        • Lagro-Janssen T.
        • Fauvel A.
        • Clair C.
        Gender awareness among medical students in a Swiss University.
        BMC Med Educ. 2020; 20: 156
        • Najjar I.
        • Socquet J.
        • Gayet-Ageron A.
        • et al.
        Prevalence and forms of gender discrimination and sexual harassment among medical students and physicians in French-speaking Switzerland: a survey.
        BMJ Open. 2022; 12: e049520
        • Martin B.V.
        United Nations: gender equality and women’s empowerment. United Nations sustainable development.
        (Available at:)
        • Gino F.
        Ending gender discrimination requires more than a training program.
        Harv Bus Rev. 2014; (Available at:)
      1. Gino, Coffman. Unconscious Bias Training That Works Increasing awareness isn’t enough. Teach people to manage their biases, change their behavior, and track their …. Harv Bus Rev.

        • International Labour Organization
        Breaking Barriers: Unconscious Gender Bias in the Workplace.
        ACT/EMP Research note, 2017
        • Creary S.J.
        • Rothbard N.
        • Scruggs J.
        Improving Workplace Culture Through Evidence-Based Diversity, Equity and Inclusion Practices.
        2021 (Available at:)
      2. (Editors MS)DEI Practices that have an Impact. MIT Sloan Management Review, 2022

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