Purpose: Past research suggests that older and female patients may receive inferior medical care across specialties due to subtle discrimination. The aim of the current study is to experimentally investigate this bias in the field of gastroenterology, particularly among medical trainees. Method: U.S. medical students and residents participated in an online survey utilizing a 2 (Medical trainee gender: male, female) x2 (patient age: 27, 67) x2 (patient gender: male, female) experimental design. Medical trainees viewed a chart describing a patient with constipation and indicated how likely they were to order various treatments. Additionally, trainees evaluated patients on perceived compliance and health consciousness. Results: 472 medical trainees from 75 institutions participated in the study. Trainees were significantly less likely to recommend the necessary treatments (comprehensive history, dietary intake information, digital rectal exam, psychological stress assessment, and routine physical exam) for older female patients than for young female patients. The digital rectal exam was recommended for a greater proportion of older male patients than young female, young male or older female patients. Additionally, male trainees were less likely to recommend necessary treatments overall as compared to female trainees. Female trainees tended to have more optimistic affective evaluations of patients, illustrating more general positivity toward patients, expecting better medical compliance from patients, and perceiving patients to be more health conscious. Conclusion: Age and gender biases are apparent in medical trainees, particularly in the diagnosis of constipation. Initiatives in medical education should be undertaken to recognize and eliminate these subtle biases.
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