Emergency Medicine Gender-specific Education

Abstract

The 2014 Academic Emergency Medicine consensus conference has taken the first step in identifying gender-specific care as an area of importance to both emergency medicine (EM) and research. To improve patient care, we need to address educational gaps in this area concurrent with research gaps. In this article, the authors highlight the need for sex-and gender-specific education in EM and propose guidelines for medical student, resident, and faculty education. Specific examples of incorporating this content into grand rounds, simulation, bedside teaching, and journal club sessions are reviewed. Future challenges and strategies to fill the gaps in the current education model are also described.ACADEMIC EMERGENCY MEDICINE 2014;21:1453-1458© 2014 by the Society for Academic Emergency Medicine C linicians have observed sex and gender differences in patient care for decades. However, these differences have been formally recognized only in recent years. The American Medical Association style guide defines sex as the classification of living things as male or female according to their reproductive organs and functions assigned by chromosomal complement. 1 This chromosomal complement affects a patient's vulnerability to disease and his or her response to medications and treatments. Gender, however, refers to a person's self-representation as man or woman or how that person is responded to by social institutions on the basis of the person's gender presentation. Frequently confined to reproductive health, sex-and gender-specific medicine (SGM) also addresses why some diseases, such as cardiovascular diseases or strokes, are more common in men versus women and whether these differences affect treatment and prognosis. In 1994, the field of SGM gained new momentum as Congress mandated the recognition of sex-and gender-based research and education for every organ system. 2 As a result of these mandates, sex and gender differences in the etiology, diagnosis, progression, outcomes, treatment, and prevention of many conditions have been described that affect care for both women and men patients in the acute care setting. Some examples of sex differences include strokes and cardiovascular conditions are more common in men and yet mortality is worse in women for the same conditions, digoxin causes more adverse events in women being treated for congestive heart failure, Brugada syndrome is 10 times more common in men due to the effect of testosterone on cardiac sodium channels, the slower metabolism of zolpidem in women puts them at increased risk for sleep-associated motor vehicle crashes, aspirin is variably effective in the treatment of myocardial infarction and stroke in men compared to women, and men have an increased susceptibility to sepsis. [3][4][5][6] Despite recent advances in gender-specific medicine, this information is largely ignored in current emergency medicine (EM) research and clinical practice. 7 The 2013 RAND Corporation report has independently documented the central role of EM in health care delivery i...

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