Background
Early studies that helped physicians understand and treat many disease processes were based on data collected mainly in men, with heart disease being a primary example. However, over time, we have come to realize that there are important differences between men and women in the pathophysiology, presentation, diagnosis, and treatment of many illnesses. Furthermore, given that 50% of the population is female, and that a much larger percentage of healthcare utilizers are women, it is essential that providers recognize and are able to care for conditions that affect women with greater frequency, including autoimmune disorders, depression and anxiety, osteoporosis, among many others, as well as those that affect only women, such as pregnancy, menses, menopause, and breast, ovarian, cervical and endometrial cancer. Physicians, regardless of specialty, will need to understand such differences in order to provide appropriate care.
Goal
To prepare students to meet the health care needs of women.
Implementation
Women’s health education at UPSOM is considered a longitudinal curriculum and is incorporated throughout the four years of medical school. Women’s health content is integrated, as appropriate, into both the pre-clinical courses and clinical clerkship. Understanding and caring for conditions specific to women serves as the primary goal of certain courses and clerkships. For those students wishing to gain additional training in the care of and study of women, a range of electives are offered
The following are examples of where women’s health topics are incorporated into the curriculum.
Patient, Physician and Society Block
Beginning during the first week of medical school, students in the Introduction to Being a Physician course start to gain an appreciation of Women’s Health issues when they work in small groups with cancer survivors on the breast cancer case. The case discussion on abortion in the Ethics, Law and Professionalism course helps students begin to understand the sensitive and challenging considerations that physicians and patients face when dealing with this subject. Students learn about women’s experiences with the health care system in sessions on behavior change across cultures, in the first-year Behavioral Medicine course.
Foundations of Medicine Block
The Immunology in Health and Disease course covers rheumatologic/ auto-immune diseases, including the prevalence of particular conditions in women. The Human Genetics course has a workshop on breast cancer, with a focus on different types of mutations, susceptibility to other forms of cancer and different approaches for treatment. The Immunology in Health and Disease course covers rheumatologic/auto-immune diseases, including the prevalence of particular of particular conditions in women. The impact of sexually transmitted infections on reproductive health is taught within the Medical Microbiology course.
Organ System Pathophysiology Block
The majority of the Reproductive and Developmental Biology course deals with women’s health. Pregnancy-related changes in pulmonary, cardiac and renal systems are covered within the segments of the Body Fluid Homeostasis course at the beginning of second year. Osteoporosis is addressed in the Endocrine course. Eating disorders are addressed in the Introduction to Psychiatry course.
Introduction to Patient Care Block
Students begin to develop breast and pelvic examination skills during the Advanced Physical Examination course during year 2. The instructional sessions are synchronized to align with related content in the Reproductive and Developmental Biology course.
Clinical Rotations
The Obstetrics and Gynecology clerkship provides vital instruction in this area. The Family Medicine clerkship provides additional instruction on specialized examination skills, and opportunities to participate in obstetrical and gynecologic care. Clinical electives allow students to rotate in a broad range of related areas, including gynecologic oncology, reproductive endocrinology, breastfeeding, urogynecology, minimally invasive gynecologic surgery, adolescent medicine, women’s health, midlife health, and family planning.
Integrated Life Sciences Course
The Infectious Disease in Obstetrics, Gynecology, and Reproductive Medicine Integrated Life Science course is one of the fourth-year courses students may choose to fulfill the ILS requirement. The course incorporates clinical, laboratory and basic science learning that helps students gain a more in-depth understanding of this integrated subject.
Area of Concentration - Women’s Health
The Area of Concentration program in Women’s Health provides interested students with an opportunity to pursue this subject in greater depth, including mentoring, experiential learning and support for research activities.
Impact
Women’s health education has been integrated in a thoughtful and deliberate manner throughout the UPSOM curriculum. Attention to the care of women has well received by students and faculty and recognized as an essential part of becoming a competent physician. Students at UPSOM leave well-prepared to respond to the unique health care needs of women, regardless of chosen specialty.