CONTEXT: Many medical students experience considerable anxiety when starting hospital experiences. OBJECTIVES: To investigate the role of gender in this transitional experience. METHOD: A questionnaire study was conducted in 1992 and 1995 to compare female and male anxieties about clinical situations they anticipated encountering. The 31-item questionnaire listed potential anxiety-provoking situations and requested the respondents' ratings of their reactions (from 1=not anxious to 4=very anxious). RESULTS: Differences in rankings between males and females were consistent between 1992 and 1995. More detailed analysis of 1995 data showed females had significantly higher totals; for 16/31 situations the difference was statistically significantly higher. For 4/31 situations male score was statistically significantly higher. Males ranked clinical situations involving intimate contact with patients significantly higher. Females scored situations involving interactions with consultants significantly higher than other situations and higher than did males. Females compared to males ranked 6/31 situations over five places different. CONCLUSIONS: Customisation of clinical introductory courses should be introduced. Earlier community-based clinical experience may help reduce non-productive anxiety.