A historical gap in research on sex differences in health outcomes has led to a lack of education on sex-based differences in pathophysiology. The primary objective of this research study was to survey pathophysiology professors of medical schools in the United States (US) to understand the current extent to which the impact of sex on disease is included in the pre-clinical curricula of undergraduate medical institutions in the US.


A survey tool was created via literature review to assess the extent of education on sex-based differences in pathophysiology. This survey was distributed using the Qualtrics electronic platform to the head professor of pathophysiology at each of the 141 Liaison Committee on Medical Education (LCME) accredited medical schools in the United States.


The survey response rate was 14.9%. The most taught topics were epidemiology of most common cancers affecting each sex and risk factors for development of osteoporosis between different sexes. Sex-based differences in zolpidem dosing, smoking cessation, and the physiologic mechanism of narcotic addiction had the least curricular coverage. 28.57% of faculty and 38.10% of faculty agree and somewhat agree, respectively, their institution provides faculty development for teaching about topics relating to sex differences in pathophysiology. Medical students are primarily evaluated on their knowledge of sex pathophysiology in the form of written examination, followed by evaluation by standardized patients, and lastly faculty observed patient interactions.


Curricular topics relating to sex-based differences in pathophysiology are taught to varying degrees in medical school preclinical curricula. Improved efforts can be made to increase instruction on specific topics and to support faculty development in teaching about sex-based differences in disease evaluation and management, enhancing the education of the next generation of physicians and facilitating better care for patients.