Gender Sensitivity and Gender-Role Ideology Among Medical Students in Germany: A Multicenter Cross-Sectional N-GAMS Study

Introduction: Sex and gender affect health, clinical reasoning, treatment decisions, and communication. Medical education should enable students to recognize clinically relevant sex- and gender-related differences without reinforcing stereotypes. The Nijmegen Gender Awareness in Medicine Scale (N-GAMS) measures gender sensitivity and gender-role ideology. This study aimed to assess these constructs among medical students in Germany. Methods: A multicenter cross-sectional survey was conducted in 2023. Of 35 medical faculties invited, nine participated. N-GAMS scores were calculated for gender sensitivity (GS), gender-role ideology toward patients (GRIP), and gender-role ideology toward doctors (GRID). Gender-group differences were examined using analysis of variance, and adjusted associations with sociodemographic, educational, and institutional variables using multivariable linear regression. Results: 424 students completed the survey. Mean scores on the five-point N-GAMS scale were 2.55 for GS, 1.85 for GRIP, and 1.73 for GRID. Gender differences were significant for GRIP and GRID, but not GS. In exploratory adjusted models, male gender was associated with higher GRIP scores than female gender (beta = 0.167, nominal p = 0.001, Holm-adjusted p = 0.017). A corresponding association was observed for GRID at the nominal level (beta = 0.130, p = 0.010), but it did not remain significant after Holm adjustment (adjusted p = 0.212). Conclusions: Gender-role stereotypes toward patients were more pronounced among male than female students. Findings support longitudinal, clinically embedded sex- and gender-sensitive medical education combining knowledge with critical reflection on stereotyping.