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Sex and gender are important determinants of healthcare that need to be taken into account for medical teaching. Education is more effective if tailored to students' subjectively-perceived needs and connected to their prior knowledge and opinions. This study explored first-year medical students thoughts about sex and gender differences in general and in specifically in healthcare, and what their educational preferences are in learning about these concepts during their medical training. Therefore six focus groups were conducted with 26 first-year medical students, 7 male and 19 female students, within one Dutch medical faculty. The discussions were audio-recorded and transcribed verbatim. After that a thematic analysis was performed which included descriptive coding, interpretative coding, and definition of overarching themes. Three major themes were identified. (1) Students' self-perception of concepts sex and gender, including three major domains: (a) The unavoidable allocation of individuals to groups, (b) The role of stereotypes, and (c) The effect of sex/gender on career choice options. (2) Students' goal orientedness in learning about sex/gender. (3) Students' struggles between the binary system of medicine and the complexity of reality. Continuous reflection during medical school might help medical students to acquire sex- and gender-sensitive competencies that can be applied in their future work. To increase awareness about the influence of sex and gender differences in healthcare and on career choices, we recommend addressing these themes explicitly early on in the medical curriculum. more...