A large and growing body of medical research shows that females and males are not the same when it comes to their health.
In fact, there are significant differences involving common diseases and conditions. These include differences in prevalence, risk factors, how diseases and conditions develop over time, and the safety and efficacy of particular treatments.
In order to meet the unique needs of women and men when it comes to their health, it is important for medical practitioners to understand these differences.
But this data-based information is not yet widely taught to medical students.
One survey of U.S. and Canadian medical schools in 2011 found that 70 percent of responding institutions did not have a formal curriculum in which the health effects of sex and gender were integrated. In addition, only 25 percent of medical students reported in 2016 that they felt prepared to manage sex and gender differences in health care.
Dr. Njeri Thande, a cardiologist and Assistant Professor of Medicine, is leading an effort with Women’s Health Research at Yale and Yale School of Medicine’s Office of Education to make sure this vital education starts as early as possible. The goal is to build a model for medical schools to fully integrate demonstrated scientific knowledge of how sex and gender influence health into their curricula.
“Changing the curriculum of a medical school can be challenging,” Thande said. “But I’m optimistic that we can leverage the uniqueness, innovation, and activism of students to make a real difference.”
In a study published March 15 in the peer-reviewed Journal of Women’s Health, Thande and her co-authors found that less than 25 percent of 548 first- and second-year lectures and workshops at Yale School of Medicine contained relevant sex and gender content. And only 8 percent of sessions included an in-depth discussion of sex and gender differences.
Even when discussions touched on sex and gender, they mostly dealt with basic biology and prevalence of diseases and conditions, not the underlying data or how sex and gender affect diagnoses, treatments, prognoses, and the effects of medication.
“If we are going to continue making up for the decades in which the health of women and sex-and-gender effects on health were not studied, we need to start today with our future physicians and researchers,” said WHRY Director Carolyn M. Mazure, Ph.D. “Moving forward, we need everyone in medicine to understand how sex and gender influence health to better treat patients and continue to build and spread this knowledge.”
Thande and her co-authors, Mazure, medical students Melinda Wang and Nisha Dalvie, and WHRY undergraduate fellow Kaveri Curlin, offered four recommendations for improving medical school curricula to incorporate data-driven conclusions about the interactions of sex, gender, and health:
- "A sex- and gender-based thread taught and coordinated by trained faculty that integrates content as well as tracks and incorporates empirical updates.
- Curriculum content on (a) the historical implications of sex or gender bias in research and (b) how to design basic and clinical research studies that adequately analyze sex and gender differences as well as other determinants of health.
- Improved coverage of sex or gender differences beyond presentation of disease, with a focus on diagnosis.
- Integration of sex and gender information into case studies reviewed in small group sessions."
Women’s Health Research at Yale is now working with Yale School of Medicine course directors to change the curriculum and provide a template for other institutions to follow.
“Since its founding, Yale School of Medicine has provided leadership to improve how we understand and treat disease,” Mazure said. “Now we are leading once again by preparing the generations to come with the knowledge and tools they need to provide health care that accounts for our individual needs.”