Exploring the perceptions of senior medical students on gender and pain: a qualitative study of the interplay between formal and hidden curricula.

Objective: Explore the perceptions of senior medical students on the relationship between gender and pain and examine how formal and hidden curricula in medical education shape their experiences.

Design: We conducted a cross-sectional qualitative interview study, using individual semistructured interviews and adhering to interpretative description methodology. We used Braun and Clarke's reflexive approach to thematic analysis to analyse our data.

Setting: Six medical schools across the UK. Data collection occurred between the autumn of 2022 and the spring of 2023.

Participants: 14 senior (penultimate or final year) medical students.

Results: We created three themes, which describe key educational forces shaping students' experiences of the relationship between gender and pain. These are (1) the sociocultural influencer, (2) the pedagogical influencer and (3) the professorial influencer. Our findings highlight the influence of both wider societal norms and students' own identities on their experiences. Further, we explore the nature and detrimental role of formal curricular gaps, and negative role modelling as a key mechanism by which a hidden curriculum relating to gender and pain exerts its influence.

Conclusions: These findings have several educational implications, including the need for a more holistic, person-centred approach to pain management within medical school curricula. Additionally, we recommend the creation of reflective spaces to engage students in critical thinking around bias and advocacy from the early stages of their training. We present actionable insights for medical educators to address issues of gender bias and pain management.