[vc_row][vc_column][vc_empty_space height=”100px”][vc_custom_heading text=”Medical Education” font_container=”tag:h1|text_align:left” use_theme_fonts=”yes”][vc_column_text]The Director of Gender and Diversity Consulting International has been engaged in the process of integrating evidence of sex and gender differences into the medical curriculum at Monash University in Australia since 2001. The goal has been to graduate doctors who understand the significance of the evidence of sex and gender differences in their patients and who practice in ways to optimise patient outcomes, based on this knowledge.

The Director is therefore, one of the few people globally with the skills and experience to ‘mainstream’ gender competence into the policies, processes and practices of a medical school and its curriculum.  This is a complex process that involves:

  • advocacy and consensus building for the process among key stake holders
  • endorsement and leadership on the issue from senior staff
  • policy and process reviews with a gender perspective
  • training of curriculum developers to integrate new evidence into curriculum and assessment
  • training and support of academic and clinical tutors
  • curriculum delivery with staged integration of content from most basic at most abstract concepts of sex and gender difference
  • evaluation, updating and modification of curriculum delivery process where necessary

The culture of medicine has very deep historical roots and in some ways is resistant to change. However, it is also a profession that is constantly responding to innovation in practice. In order to achieve the cultural change necessary to medicine it must simply be presented for what it is: an evidence-based innovation in practice that will improve patient outcomes. Our experience within the medical curriculum at Monash has been that clinicians who deal with these issues amongst their patients every day welcome the opportunity to teach it from evidence, rather than to allow their students to learn it through trial and error as they were forced to do as students.  Read more on integrating gender into medical education…

The same is true for all medical and allied health related fields including nursing, paramedics, midwifery and occupational therapy to name a few. Likewise, gender is just one social variable that can be integrated into medical curricula using this process, issues of race, ethnicity and language etc. may also be integrated through this process to achieve cultural competence; an issue of particular importance in the modern world where populations of both patients and doctors and other health service providers are increasingly diverse.

Over the past decade the volume of medical evidence about sex and gender differences1 in the presentation, diagnosis and management of disease has increased exponentially. Quite apart from differences in patients due to gender2, the doctor’s gender also impacts on the way they relate with their patients3. Despite this increased knowledge about gender differences, it has had minimal impact on the clinical approach used by doctors. Most doctors show little variation in practice from that which they learned at medical school. Therefore to ensure that information regarding sex and gender difference is effectively integrated into practice, experts recently agreed that it must be taught in medical schools4.

The integration of gender competence or ‘a gender mainstreaming programme’ is aimed at addressing the imbalance between the male oriented medicine that is taught and practised in medical school and the coherent ‘gender competent’ strategies that are needed for modern clinical practice in health care settings internationally. Currently medical students learn most of their clinical practices from clinical educators, practicing clinicians, whom students observe, are taught and graded by, in the hospital or community setting. Until recently the apprenticeship model was the most prevalent in medical education, so if clinicians are not trained to teach innovation effectively, they will simply teach as they were taught and teach to practise as they do. It is therefore, not enough to integrate gender competence into the curriculum. It must be ‘mainstreamed’; tutors must also be trained to teach the new curriculum effectively and this change must be supported and role modelled by senior clinicians and decision makers within the curriculum delivery process. To change the teaching of medicine it is necessary to modify the culture of both academic and clinical teaching practices5.

  1. Sex Differences: Biological differences between males and female. Gender differences: differences between men and women based on social role.
  2. Pinn VW (2003). Sex and gender factors in medical studies: implications for health and clinical practice. JAMA 289: 397-399.
  3. Zaharias, G, Piterman, L (2004). “Doctors and patients: gender interaction in the consultation.” Academic Medicine 79(2): 148-155.
  4. Consensus at the 4th Congress of the International Society of Gender Medicine held in Berlin from 6-8th November, 2009.
  5. Verdonk, P, Benschop, Y, et al. (2008). “Making a gender difference: Case studies of gender mainstreaming in medical education.” Medical Teacher 30:e194-e201