Background: Despite the increase in female medical students and clinicians, gender disparities continue to exist for female clinicians today, from limits on upward mobility and leadership positions to unequal pay and more. Within medical education, existing research shows male students outperform female students on the USMLE Step 1 licensing examination, which has longer-term ramifications on residency specialty selection and placement. In non-medical education, it has been shown that in-class verbal participation correlates with academic success and test scores. Research is lacking on whether verbal participation disparities exist during preclinical medical education, and if they do, what the significance of this may be for female trainees and the educational climate.

Purpose: This descriptive cohort study explores the extent to which gender disparities exist at the level of preclinical medical education, using the proxy metric of verbal participation in class. We aimed to (1) quantify any gender disparities in verbal participation in medical school small work groups, and (2) to examine whether factors such as facilitator gender or facilitation style impact female verbal participation.

Description: We collected covert observational data over a 4-week period during a 1st year basic science course. Ten small work group sessions were observed and unique verbal participation events were counted by gender. Facilitator gender, gender composition of group, and presence or absence of inclusionary comments by facilitator were also recorded. Descriptive statistics analysis revealed an imbalance in average verbal participation events between males and females of >2:1 when adjusted for group composition. Facilitator gender did not have an impact on this imbalance. The absence of inclusive facilitation increased the disparity in participation events to >4:1. At least one instance of inclusive facilitation per session increased both male and female participation and narrowed but did not close the gender gap.

Conclusions: Participation gender disparities exist in preclinical medical education. More research is needed to explore implications, as well as interventions by which gender equality can be promoted in the small work group microcosm and beyond.