The quality of medical education is pivotal to the standard of healthcare, shaping both the clinical competence of future physicians and their sensitivity to patient diversity (Torralba and Katz, 2020). Anatomy, as one of the earliest stages of medical education, forms the foundation of biomedical knowledge and serves as the basis for further clinical reasoning (Estai and Bunt, 2016, Keim et al., 2023, Singh et al., 2015). Anatomical atlases, alongside dissection classes, remain a primary educational tool, shaping students’ understanding of body structure (Choi-Lundberg et al., 2016, Cullinane and Barry, 2023, Henssen et al., 2025). However, previous studies have demonstrated a marked sex-related imbalance in the representation of the human body. Illustrations in atlases and textbooks predominantly depict male figures, while female figures are shown mainly in the context of the reproductive system (Beresheim et al., 2024; Mendelsohn et al., 1994; Parker et al., 2017). Such asymmetry extends beyond descriptive anatomy and may implicitly frame the male body as the default anatomical reference, while the female body is portrayed as anatomically “specialised” or context-dependent. This pattern of representation may contribute to reinforcing gender stereotypes and influence how female patients are perceived in clinical practice (Morgan et al., 2014). Educational materials do not merely transmit factual knowledge but also shape professional norms, expectations, and sensitivity to diversity, raising concerns that persistent representational imbalance may indirectly affect future clinical reasoning and patient care (Beresheim et al., 2024). At the same time, there is a risk of reproducing existing biases among future physicians.

An important unresolved question is whether the sex imbalance documented in anatomical atlases has practical educational relevance and to what extent it is recognised by learners themselves. Students’ perceptions are particularly important, as they represent the immediate recipients of anatomical imagery and may internalise implicit messages conveyed through visual materials. Most existing studies have focused on content analyses of textbooks and atlases, quantitatively documenting disparities in representation (Beresheim et al., 2024, Louie and Wilkes, 2018). By contrast, empirical data on how medical students perceive and interpret these representational patterns remain scarce. Moreover, there is limited evidence on whether perceptions differ according to students’ sex or stage of medical training, despite theoretical and empirical indications that both individual characteristics and educational exposure may shape sensitivity to bias in learning materials. Against this background, the present study addresses a gap in the literature by examining medical students’ perceptions of sex representation in anatomical atlases, rather than the content of the atlases themselves. By focusing on students’ views, the study shifts the perspective from descriptive analyses of educational resources to the lived educational experience of learners.

Aim of the study The aim of this study was to assess to what extent medical students recognise gender imbalance in anatomical atlases. Specifically, we examined whether perceptions differ according to students’ sex and year of study, and compared the opinions of students from two Polish medical universities with different educational traditions.