Gender differences in the effect of medical humanities program on medical students’ empathy: a prospective longitudinal study

Background: Previous studies have suggested that Medical students’ empathy declines during medical school, especially during the clinical studies. The aim of this study was to examine. Changes in medical students’ empathy during their first clinical experience, and to determine the impact of gender and humanities curriculum on empathy changes. Methods: In this prospective longitudinal study, 262 4th year students from three consecutive classes were assessed. Empathy was assessed before and at 4th-year-end, using the Jefferson Scale of Physician Empathy-Student Version (JSPE-S). The three classes differed in humanities curriculum [limited Medical Humanities (MH_(lim)) vs. extended Medical Humanities (MH_(ext))], and in admission system [Personal Interview (PI) vs. multiple mini interviews (MMI)]. Results: Overall, there was a small but significant decrease in JSPE-S during the fourth year (114.40 ± 11.32 vs. 112.75 ± 14.19, p = 0.034). Among men there was a statistically significant decline in JSPE-S during the fourth year, and the MH_(ext) (but not the MH_(lim)) was associated with the decline (t₍₃₅₎ = 2.38, p = 0.023). Women students showed no decline in empathy during the fourth-year of studies, regardless of type of humanities program. In addition, women who participated in MH_(ext) had a higher JSPE-S scores during the 4th -year as compared to women who participated in MH_(lim). Conclusion: Pre-clinical humanities program was associated with a decline in empathy among men medical students during the fourth-year of medical studies. Gender differences in response to medical humanities programs require further study.