{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:00:52Z","timestamp":1760148052241,"version":"build-2065373602"},"reference-count":47,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Symmetry"],"abstract":"<jats:p>Background: Studies have shown that symmetry plays an aesthetic role and has a positive effect on the perception of human faces. Our work hypothesizes that facial symmetry positively correlates with physical attractiveness and, thus, with higher visual evaluations of future doctors. Materials and methods: Observational study of 46 students (26 women and 20 men), comparing subjective indicators, symmetry of their facial features, and students\u2019 academic performance. Results: We found no correlation between these subjective results and an objective factor of symmetry facial recognition. User evaluators\u2019 subjective assessments of students\u2019 physical appearance showed significant gender differences for almost all the domains assessed. Moreover, these variables were correlated to each other: women were perceived more positively than men. There were also correlations in the variables related to academic performance but no gender differences. We did not observe any relationship between subjective variables related to physical appearance and objective ones related to academic performance. Conclusion: Facial symmetry was not correlated with positive physical appearance and, therefore, with a better evaluation of future doctors by patients. Users perceive women physicians more positively, despite there being no difference at an academic level.<\/jats:p>","DOI":"10.3390\/sym15040787","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T04:31:05Z","timestamp":1679632265000},"page":"787","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Facial Symmetry and Physical Appearance in Patients Perception of Medical Students: A Gender Differences Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2984-5165","authenticated-orcid":false,"given":"Francisco","family":"S\u00e1nchez-Ferrer","sequence":"first","affiliation":[{"name":"Facultad de Medicina, Campus de Sant Joan d\u2019Alacant, Universidad Miguel Hern\u00e1ndez de Elche, Alicante-Valencia N 332, 03550 San Juan de Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Dolores","family":"Grima-Murcia","sequence":"additional","affiliation":[{"name":"Instituto de Bioingenier\u00eda, CIBER BBN, Avinguda de la Universitat d\u2019Elx, s\/n, 03202 Elche, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0601-0213","authenticated-orcid":false,"given":"Ana Pilar","family":"Nso-Roca","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Campus de Sant Joan d\u2019Alacant, Universidad Miguel Hern\u00e1ndez de Elche, Alicante-Valencia N 332, 03550 San Juan de Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7052-6011","authenticated-orcid":false,"given":"Eduardo","family":"Fern\u00e1ndez-Jover","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Campus de Sant Joan d\u2019Alacant, Universidad Miguel Hern\u00e1ndez de Elche, Alicante-Valencia N 332, 03550 San Juan de Alicante, Spain"},{"name":"Instituto de Bioingenier\u00eda, CIBER BBN, Avinguda de la Universitat d\u2019Elx, s\/n, 03202 Elche, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1097\/01.PRS.0000060105.63335.0C","article-title":"Perceived functional impact of abnormal facial appearance","volume":"111","author":"Rankin","year":"2003","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3200\/GENP.133.1.19-35","article-title":"Hot or Not: Do Professors Perceived as Physically Attractive Receive Higher Student Evaluations?","volume":"133","author":"Riniolo","year":"2006","journal-title":"J. Gen. Psychol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bertamini, M., Makin, A., and Pecchinenda, A. (2013). Testing Whether and When Abstract Symmetric Patterns Produce Affective Responses. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0068403"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"428250","DOI":"10.1155\/2014\/428250","article-title":"Evaluation of Facial Beauty Using Anthropometric Proportions","volume":"2014","author":"Milutinovic","year":"2014","journal-title":"Sci. World J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/368239a0","article-title":"Facial shape and judgements of female attractiveness","volume":"368","author":"Perrett","year":"1994","journal-title":"Nature"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/BF02692202","article-title":"Criteria of facial attractiveness in five populations","volume":"4","author":"Jones","year":"1993","journal-title":"Hum. Nat."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/S1364-6613(99)01403-5","article-title":"Facial attractiveness","volume":"3","author":"Thornhill","year":"1999","journal-title":"Trends. Cogn. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1098\/rspb.1999.0866","article-title":"Facial attractiveness, symmetry and cues of good genes","volume":"266","author":"Scheib","year":"1999","journal-title":"Proc. R. Soc. B Biol. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Jones, A.L., and Jaeger, B. (2019). Biological Bases of Beauty Revisited: The Effect of Symmetry, Averageness, and Sexual Dimorphism on Female Facial Attractiveness. Symmetry, 11.","DOI":"10.31234\/osf.io\/xreu6"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1037\/0012-1649.31.3.464","article-title":"Infant attractiveness predicts maternal behaviors and attitudes","volume":"31","author":"Langlois","year":"1995","journal-title":"Dev. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1037\/0012-1649.35.3.848","article-title":"Infant preferences for attractive faces: A cognitive explanation","volume":"35","author":"Rubenstein","year":"1999","journal-title":"Dev. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1042\/ETLS20220025","article-title":"Developmental instability, fluctuating asymmetry, and human psychological science","volume":"6","author":"Gangestad","year":"2022","journal-title":"Emerg. Top. Life Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"103311","DOI":"10.1016\/j.actpsy.2021.103311","article-title":"Normality mediates the effect of symmetry on facial attractiveness","volume":"217","author":"Zheng","year":"2021","journal-title":"Acta Psychol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1027\/1618-3169.53.4.268","article-title":"Investigating the mechanisms underlying affective priming effects using a conditional pronunciation task","volume":"53","author":"Pecchinenda","year":"2006","journal-title":"Exp. Psychol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/j.1469-185X.1990.tb01186.x","article-title":"Fluctuating asymmetry: An Epigenetic measure of stress","volume":"65","author":"Parsons","year":"1990","journal-title":"Biol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/0162-3095(93)90009-7","article-title":"Pathogen prevalence and human mate preferences","volume":"14","author":"Gangestad","year":"1993","journal-title":"Ethol. Sociobiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1017\/S0006323197005082","article-title":"Developmental stability, disease and medicine","volume":"72","author":"Thornhill","year":"1997","journal-title":"Biol. Rev. Camb. Philos. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Quinto-S\u00e1nchez, M., Cintas, C., De Cerqueira, C.C.S., Ramallo, V., Acu\u00f1a-Alonzo, V., Adhikari, K., Castillo, L., Gomez-Vald\u00e9s, J., Everardo, P., and De Avila, F. (2017). Socioeconomic status is not related with facial fluctuating asymmetry: Evidence from latin-american populations. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0172418"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1037\/0033-2909.110.1.109","article-title":"What is beautiful is good, but\u2026: A meta-analytic review of research on the physical attractiveness stereotype","volume":"110","author":"Eagly","year":"1991","journal-title":"Psychol. Bull."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/00913367.1982.10672807","article-title":"The Credibility of Physically Attractive Communicators: A Review","volume":"11","author":"Joseph","year":"1982","journal-title":"J. Advert."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kleisner, K., Chv\u00e1talov\u00e1, V., and Flegr, J. (2014). Perceived Intelligence Is Associated with Measured Intelligence in Men but Not Women. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0081237"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1177\/1474704920980642","article-title":"Do We See Masculine Faces as Competent and Feminine Faces as Warm? Effects of Sexual Dimorphism on Facial Perception","volume":"18","author":"Wen","year":"2020","journal-title":"Evol. Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1037\/0033-2909.128.5.699","article-title":"A cross-cultural analysis of the behavior of women and men: Implications for the origins of sex differences","volume":"128","author":"Wood","year":"2002","journal-title":"Psychol. Bull."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/medu.12420","article-title":"How do medical students form impressions of the effectiveness of classroom teachers?","volume":"48","author":"Rannelli","year":"2014","journal-title":"Med. Educ."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1002\/bsl.939","article-title":"When emotionality trumps reason: A study of individual processing style and juror bias","volume":"28","author":"Gunnell","year":"2010","journal-title":"Behav. Sci. Law"},{"key":"ref_26","first-page":"1141","article-title":"Medicine is not gender-neutral: Influence of physician sex on medical care","volume":"152","year":"2008","journal-title":"Ned. Tijdschr. Geneeskd."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1046\/j.1525-1497.2001.016004218.x","article-title":"Does physician gender affect satisfaction of men and women visiting the emergency department?","volume":"16","author":"Derose","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_28","first-page":"268","article-title":"Patient preference and stereotype about the gender of the family physician","volume":"23","author":"Delgado","year":"1999","journal-title":"Aten Primaria"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/j.1365-2796.2008.01967.x","article-title":"Physician gender is associated with the quality of type 2 diabetes care","volume":"264","author":"Berthold","year":"2008","journal-title":"J. Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/01.pec.0000175450.31040.df","article-title":"\u201cDoctor\u201d or \u201cdoctora\u201d: Do patients care?","volume":"21","author":"Waseem","year":"2005","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_31","first-page":"29","article-title":"Analysis of the objective structured clinical examination (OSCE) of the sixth year in the School of Medicine of the Miguel Hern\u00e1ndez University of Elche","volume":"20","author":"Ramos","year":"2019","journal-title":"Educ. Medica."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1037\/xhp0000685","article-title":"Comparing theory-driven and data-driven attractiveness models using images of real women\u2019s faces","volume":"45","author":"Holzleitner","year":"2019","journal-title":"J. Exp. Psychol. Hum. Percept. Perform."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.evolhumbehav.2009.06.005","article-title":"The relative importance of the face and body in judgments of human physical attractiveness","volume":"30","author":"Currie","year":"2009","journal-title":"Evol. Hum. Behav."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.smr.2019.04.004","article-title":"The role of facial attractiveness in tennis TV-viewership","volume":"23","author":"Dietl","year":"2020","journal-title":"Sport Manag. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses","volume":"41","author":"Erdfelder","year":"2009","journal-title":"Behav. Res. Methods"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"13","DOI":"10.20982\/tqmp.04.1.p013","article-title":"The Mann-Whitney U: A Test for Assessing Whether Two Independent Samples Come from the Same Distribution","volume":"4","author":"Nachar","year":"2008","journal-title":"Tutor. Quant. Methods Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1097\/SCS.0000000000008662","article-title":"Associations of Facial Proportionality, Attractiveness, and Character Traits","volume":"33","author":"Villavisanis","year":"2022","journal-title":"J. Craniofac. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1002\/ajhb.22657","article-title":"The relationship between facial shape asymmetry and attractiveness in Mexican students","volume":"27","author":"Farrera","year":"2015","journal-title":"Am. J. Hum. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ekrami, O., Claes, P., Van Assche, E., Shriver, M.D., Weinberg, S.M., Marazita, M.L., Walsh, S., and Van Dongen, S. (2021). Fluctuating Asymmetry and Sexual Dimorphism in Human Facial Morphology: A Multi-Variate Study. Symmetry, 13.","DOI":"10.3390\/sym13020304"},{"key":"ref_40","first-page":"1995","article-title":"Second to fourth digit ratio and face shape","volume":"272","author":"Fink","year":"2005","journal-title":"Proc. Biol. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1007\/s10508-012-9917-7","article-title":"Fluctuating asymmetry and masculinity\/femininity in humans: A meta-analysis","volume":"41","year":"2012","journal-title":"Arch. Sex. Behav."},{"key":"ref_42","first-page":"24","article-title":"Physician gender and patient care","volume":"6","author":"Arouni","year":"2003","journal-title":"J. Gend. Specif. Med."},{"key":"ref_43","first-page":"1","article-title":"Spain: Health System Review","volume":"20","author":"Oliva","year":"2018","journal-title":"Health Syst. Transit."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.pec.2007.03.020","article-title":"Disentangling physician sex and physician communication style: Their effects on patient satisfaction in a virtual medical visit","volume":"68","author":"Hall","year":"2007","journal-title":"Patient Educ. Couns."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jss.2018.06.014","article-title":"Is There Gender Bias on the American Board of Surgery General Surgery Certifying Examination?","volume":"237","author":"Ong","year":"2019","journal-title":"J. Surg. Res."},{"key":"ref_46","first-page":"9","article-title":"Facial beauty\u2013Establishing a universal standard","volume":"15","author":"Jefferson","year":"2004","journal-title":"Int. J. Orthod. Milwaukee"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1111\/j.1467-9280.2005.01610.x","article-title":"Variation in perceived attractiveness: Differences between dynamic and static faces","volume":"16","author":"Rubenstein","year":"2005","journal-title":"Psychol. Sci."}],"container-title":["Symmetry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-8994\/15\/4\/787\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:01:54Z","timestamp":1760122914000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-8994\/15\/4\/787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,23]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["sym15040787"],"URL":"https:\/\/doi.org\/10.3390\/sym15040787","relation":{},"ISSN":["2073-8994"],"issn-type":[{"type":"electronic","value":"2073-8994"}],"subject":[],"published":{"date-parts":[[2023,3,23]]}}}