Abstract
BackgroundAddressing healthcare disparities is a national priority for initiatives in precision and individualized medicine. An essential component of precision medicine is the understanding that sex and gender influence health and disease. Whether these issues are addressed in post-graduate medical education curricula is unknown.MethodsA questionnaire was designed and administered to residents across the Mayo Clinic enterprise to assess current knowledge of sex and gender medicine in a large program of post-graduate medical education and to identify barriers and preferred teaching methods for addressing sex and gender issues in health and disease. Descriptive and qualitative thematic analyses of the survey responses were compiled and analyzed.ResultsResponses were collected from 271 residents (response rate 17.2 %; 54 % female; 46 % male). A broad cross-section of training programs on all Mayo Clinic campuses (Arizona, Minnesota, and Florida) was represented. Sixteen percent of the respondents reported they had never had an instructor or preceptor discuss how a patient’s sex or gender impacted their care of a patient; 55 % said this happened only occasionally. Of medical knowledge questions about established sex- and gender-related differences, 48 % were answered incorrectly or “unsure.” Qualitative thematic analysis showed that many trainees do not understand the potential impact of sex and gender on their clinical practice and/or believe it does not pertain to their specialty. A higher percentage of female participants agreed it was important to consider a patient’s sex and gender when providing patient care (60.4 vs. 38.7 %, p = 0.02), and more male than female participants had participated in research that included sex and/or gender as a variable (59.6 vs. 39.0 %, p < 0.01).ConclusionsCurriculum gaps exist in post-graduate medical training regarding sex- and gender-based medicine, and residents often do not fully understand how these concepts impact their patients’ care. Reviewing the definition of sex- and gender-based medicine and integrating these concepts into existing curricula can help close these knowledge gaps. As the practice of medicine becomes more individualized, it is essential to equip physicians with an understanding of how a patient’s sex and gender impacts their health to provide the highest value care.Electronic supplementary materialThe online version of this article (doi:10.1186/s13293-016-0097-3) contains supplementary material, which is available to authorized users.
Highlights
Addressing healthcare disparities is a national priority for initiatives in precision and individualized medicine
Precision medicine, which focuses on the genomic, molecular, and cellular interactions that lead to health and disease, is a national priority
The 1993 National Institutes of Health (NIH) Revitalization Act required inclusion of women in clinical studies, but despite this, women remain under-represented in clinical trials, while data from trials are typically not analyzed by sex and the translation of sex and gender-based science into practice remains inadequate [6,7,8,9]
Summary
Addressing healthcare disparities is a national priority for initiatives in precision and individualized medicine. The 1993 National Institutes of Health (NIH) Revitalization Act required inclusion of women in clinical studies, but despite this, women remain under-represented in clinical trials, while data from trials are typically not analyzed by sex and the translation of sex and gender-based science into practice remains inadequate [6,7,8,9]. Improving these areas is the focus of new NIH initiatives
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