Evaluation of curricular relevance and actual integration of sex/gender and cultural competencies by final year medical students: effects of student diversity subgroups and curriculum

Background: Diversity issues play a key role in medical practice and have recently been more explicitly integrated into undergraduate medical curricula in Europe and worldwide. However, research on students´ perspectives on the relevance and curricular integration of diversity issues, such as sex/gender and culture-sensitive competencies, is still limited. Methods: The Charité Berlin (Germany) ran in parallel a traditional and a competency-based medical program. Diversity perspectives, especially sex and gender aspects, were systematically integrated into the new curriculum. In 2016, an online questionnaire was sent to all medical students in their final clerkship year of both programs. Students provided diversity-related information (sex/gender, age, number of children, migration background or disability) and rated the relevance of sex/gender and culture-sensitive competencies and the integration into their study program. They also rated their preparedness for the final year clerkships and for working as a physician. Results: The included 184 students considered sex/gender and culture-sensitive competencies to be very relevant or relevant (62%; 73%). The ratings of the relevance are independent of the curriculum and significantly higher in female students. Regarding curricular integration, 69% of the students of the traditional curriculum evaluated the degree of implementation as minor, whereas 83% students of the new curriculum rated the degree of implementation as extensive. Degrees of preparedness for the workplace were significantly higher in students from the new curriculum, with no significant effects by sex/gender. Age group, having a child, migration background or a disability had separate effects on the students’ ratings. Conclusions: Medical students in their final clerkship year rated sex/gender and culture-sensitive competencies as relevant; this was independent from their study program. Their ratings provide complementary evidence that our systematic approach to implementation resulted in a successful curricular integration.