Gender awareness in a medical curriculum: Surveying final year students undertaking a Women's Health rotation

Dear Sir

Over the last two decades, gender awareness, particularly gender sensitivity, has been emerging as an important consideration in the practice of medicine for doctors and patients alike. There is a large body of research demonstrating that men and women differ significantly in matters of health: whether it concerns their presentation; risk factors; symptoms; or experiences of disease. However, gender awareness goes beyond recognising these differences: men and women also experience socially mediated problems with different consequences to their health. Health professional's failure to appreciate these differences disadvantages both male and female patients (Verdonk et al. 2008). In an attempt to address inequalities that have arisen as a result of stereotyped gender roles and unequal gender-relations, the WHO has developed policies on the importance of integrating gender awareness into medical education. Its success depends on the way that gender awareness teaching is implemented within medical training (WHO 2006).

A study was undertaken at an Australian university in order to evaluate the effect that a Women's Health (WH) rotation (including an intensive week of teaching) had on final-year medical students’ level of gender awareness. Final-year students undertaking a WH rotation between February and July 2011 (n = 30) completed the validated N-GAMS survey following one week of classroom teaching and at the completion of the rotation. Responses were then compared to students who had not undertaken this rotation (n = 33). The survey consisted of 32 items: 14 questions concerning gender sensitivity and 18 questions addressing gender role ideologies toward doctors and patients (Verdonk et al. 2008). It was found that there was a significant difference in gender sensitivity between the students who received one week of WH teaching when compared to those who did not (p < 0.05). At the completion of the rotation, this significant difference was no longer present when gender differences between groups were controlled for. Based on these results, it was concluded that initially, WH students had a higher level of gender sensitivity when compared to those who do not receive WH teaching. Seven weeks later significant difference between the groups was observed when gender differences were taken into account. This has the implication that the initial increase in gender sensitivity may not be a permanent change.

These results are important as previous research has shown that competent health professionals need to maintain a high level of gender sensitivity in order to practice effectively, and that medical education is an important target to achieve this goal. To determine whether exposure to the WH course directly improves gender sensitivity, further investigation is needed. In order to ensure that this medical curriculum (and others with a similar teaching format) follows the WHO recommendation to integrate gender sensitivity into medical education, this research should be undertaken and be reported on accordingly.