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Notes -
Depends a lot on where you look.
Urban academic is depressing, mostly because of the combination of the gender mismatch (almost 2x as many women as men nowadays AFAIK, certainly at least at my medically oriented university) and most women nevertheless expecting their partner to be university educated as a bare minimum, and there is also aggressive political filtering. There are still plenty of well-adjusted couples of course, but also just many clearly unhappy single women, often with blatant dysfunctional coping behaviour. A lot of hostility/resentment towards men in general, too. Gender norms around kids are also a bit drama-heavy; The women all want to theoretically continue their career while simultaneously in practice staying home with the kids as long as possible. And when it predictably doesn't work out, somehow the man is at fault. All very typically western cosmopolitan, I guess. The men aren't perfect, either, of course; but what strikes me is that the worst are primarily egotistical (sleeping around, generally doing stuff with no concern for their partner), while the worst women are self-hurting dysfunctional.
The urban poor, of course, are awful, but they're awful in every other way as well, so it's not particularly surprising.
Rural middle class, at least where I'm from and from what I heard from a few acquaintances' country background, is doing well. Dating is still mostly from work, partying or extended friend groups; App is the option of last resort and not held in high regard. For an example, my main old school clique is 15 people, of which 2 seem headed for permanent bachelorhood (one of which almost surely is a closeted gay, why he doesn't come out is a mystery to us all, we really don't mind), 1 has had relationship but I'm not sure currently, everyone else is in a stable relationship (well, one is an incorrigible philanderer, but his current relationship has been a few years now, so I'll give him the benefit of the doubt). We have 12 kids now afaik, as usual mostly the girls but the guys are also moving after. We're early thirties, so no worries from me that we'll hit 2+ TFR. In my second old school clique, 4 people, everyone has been in stable relationships for ages now and two of the others just now had their first child, too. They also intend to have more so again no worries. I've lost contact with most of my acquaintances from school of course, but if I randomly see them they almost always have a partner and often have kids, too. Gender norms are pretty easy here, women can do what they want, but when the kids come they want to be mom anyway.
But this is millenials. I have little idea how gen z is doing, to be honest.
Is such a lopsided sex ratio usual for a medical university?
At least in germany, medicine as a whole has been 60%+ female, tendency upwards. Specialty study programs tend to be similarly, or even more lopsided: I studied a special "applied math in biology and medicine" course, which was around 20 women to 4 guys (admittedly partially due to many guys dropping out in the first semester). Women don't like math, but at least a few are good at it, and if you give it a focus on something they actually do like... The same goes for several specialty courses we have here on medical / biophysics or -informatics, even engineering, all of which naively may sound male-dominated, but from my impression were also 60%+ female. Just attach "medical" (or "media", for that matter) to any course name, and the women will flock to you, apparently.
Then you have the degrees which used to be Ausbildung, such as midwifery, and some other such as nutritional biology, which combine very low standards and a lopsided gender ratio.
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