Training emergency physicians in sex- and gender-based medicine: assessing attitudes of program directors and residency graduates.

Tracy E Madsen,Alyson J Mcgregor

doi:10.1186/s13293-016-0098-2

Tracy E Madsen, Alyson J Mcgregor

Open Access

https://doi.org/10.1186/s13293-016-0098-2

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Abstract

BackgroundSex and gender influence disease presentation, treatment, healthcare access, and long-term outcomes. It is uncertain to what extent sex- and gender-based medicine (SGBM) content has been integrated into emergency medicine (EM) residency curricula. We aimed to determine if SGBM is being taught in EM residency training, if EM residency program directors (PDs) declare SGBM a curriculum priority, and if recent graduates (RGs) of EM residency programs declare SGBM as relevant to their practice.MethodsTwo hundred twenty-six RGs and 54 PDs of US ACGME EM residency programs completed a web-based survey. Descriptive statistics were used to describe RGs’ attitudes towards whether they had received instruction in SGBM overall and in specific content areas and attitudes about the relevance of SGBM to EM practice. Descriptive statistics were also used to describe whether SGBM was considered a curriculum priority by PDs and potential barriers to implementing SGBM into curricula.Results43.2 % of RGs felt they received adequate training on gender differences in emergent conditions. Only 16.3 % of PDs believed gender differences in disease presentation were a curriculum priority. In contrast, the majority (59.5 %) of RGs felt that gender differences in emergency conditions were relevant to their practice. PDs listed completing curricular demands (76.6 %), lack of evidence-based content (53.2 %), and lack of faculty interest (36.2 %) as the largest obstacles to curriculum integration.ConclusionsOver half of the RGs of ACGME EM residencies felt that their instruction in SGBM was not adequate, and SGBM was not reported as a consistent priority among PDs.Electronic supplementary materialThe online version of this article (doi:10.1186/s13293-016-0098-2) contains supplementary material, which is available to authorized users.

Highlights

Sex and gender influence disease presentation, treatment, healthcare access, and long-term outcomes
Sex and gender differences exist in disease conditions including acute coronary syndrome, stroke, COPD, and substance abuse, conditions that account for large numbers of emergency department visits each year [1,2,3,4]
The objectives of our study were (1) to determine if sex and gender differences in diagnosis and treatment of common emergency complaints are being taught in emergency medicine (EM) residency training, (2) to determine if EM residency program directors (PDs) declared this a curriculum priority, and (3) to determine if recent graduates (RGs) of EM residency programs declared sex- and gender-based curriculum as being relevant to their practice

Summary

Introduction

Sex and gender influence disease presentation, treatment, healthcare access, and long-term outcomes. Sex and gender affect many facets of acute disease including pathophysiology, risk factors, clinical presentation, treatment, and outcomes. The field of women’s health has classically focused on reproductive health and has not consistently included content on sex- and gender-based medicine (SGBM) despite an increasing amount of evidence that clinically important sex- and gender differences exist in a wide variety of acute conditions. One internal medicine residency program described the development and implementation of a multidisciplinary women’s health program with a small component of content on gender differences and disparities [5]. Curricula integrated into internal medicine training programs have focused on conditions specific to women including breast cancer and gynecological conditions, with a paucity of content on sex and gender differences in conditions that affect both genders [5, 7]. With the exception of a recent publication on the development of SGBM curriculum for residents and fellows [9], the extent to which SGBM and women’s health content has been integrated into emergency medicine (EM) residency curriculum is unknown

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