more on gender and medical education…

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

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