title: Muslim women and medical students in the clinical encounter.
abstract: BACKGROUND
  Increasingly, male medical students report being refused by female patients, particularly in obstetrics and gynaecology, which is impacting on recruitment into the discipline. However, little has been documented in terms of Muslim patients and medical students in the clinical consultation.
  
  
  METHODS
  Female Emirati nationals (n = 218) attending out-patient clinics at a public hospital in Al Ain, United Arab Emirates (UAE), were interviewed by medical students. Participants were provided with four hypothetical clinical scenarios (three personal, one concerning a pre-pubertal child) and asked whether they would allow male and female students to be present at a consultation, take a history or perform an examination. They were also canvassed about their past experiences with medical students and their social responsibility to contribute towards the training of Emirati doctors.
  
  
  RESULTS
  Significant differences were recorded in terms of female versus male student involvement for all activities (P < 0.05-0.0005). For gynaecological and abdominal problems, patients would generally refuse male students. More than 50% of interviewees would not allow a male student to examine their face. Students of either gender could, however, examine their 8-year-old child. Although 47% of the women had had previous clinical encounters with students, in only 58% of consultations had the attending doctor asked their permission. Despite this, the women had generally felt comfortable, although satisfaction decreased with increasing age (P = 0.088). Almost 90% of the women believed that Emiratis had a social responsibility to contribute towards the training of Emirati doctors, but this decreased with increasing income (P = 0.004).
  
  
  CONCLUSIONS
  As many medical students will encounter Muslim patients during their training, they need to be sensitive to religious and cultural issues, particularly for personal examinations. In contexts where most patients are Muslim, alternative options (e.g. manikins, international rotations) may be required for male students. In the UAE, patient education may improve history-taking opportunities but will probably not transcend religious and cultural beliefs without intervention from religious leaders.
authors.affiliation: Department of Medical Education, United Arab Emirates University, Al Ain, UAE. mcleanm@uaeu.ac.ae
authors.forename: Michelle
authors.initials: M
authors.lastname: McLean
authors.forename: Salma
authors.initials: S
authors.lastname: Al Ahbabi
authors.forename: Mouza
authors.initials: M
authors.lastname: Al Ameri
authors.forename: Muneera
authors.initials: M
authors.lastname: Al Mansoori
authors.forename: Fatima
authors.initials: F
authors.lastname: Al Yahyaei
authors.forename: Roos
authors.initials: R
authors.lastname: Bernsen
mesh_terms: D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002755:Choice Behavior; D004501:Education, Medical / Q000379:methods*; D005145:Face; D005260:Female; D006176:Gynecology; D006801:Humans; D007514:Islam / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D012737:Sex Factors; D012941:Social Responsibility; D013337:Students, Medical; D011795:Surveys and Questionnaires; D014479:United Arab Emirates; D055815:Young Adult