Meeting the Need for Women's Health Training in Gastroenterology: Creation of a Women's Digestive Disorders Program at Brown University

Abstract

Background: Despite training requirements, knowledge and self-efficacy in women's health issues remain inadequate in many fields. In gastroenterology, nearly 60% of patients are women, and many disorders are more common in women. Adequate training in gastrointestinal (GI) women's health is, therefore, critical for gastroenterologists. Objectives: (1) To create a core faculty in GI women's health, (2) to develop a GI women's health curriculum, (3) to provide didactic education and clinical experiences in GI women's health, (4) to produce self-efficacy in the evaluation and management of GI women's health issues, and (5) to develop academic gastroenterologists focused on GI women's health. Methods: We assembled a multidisciplinary group of GI women's health experts dedicated to training and mentoring GI fellows. We also held focus groups to determine the unmet needs in the management of the GI health of female patients in our community. Results from this needs assessment formed the foci of our program. In 2002, we introduced a 2-month rotation in GI women's health. Then, in 2005, we introduced a 3-year women's health pathway for trainees committed to academic careers. Results: Between 2002 and 2008, 13 fellows who participated in the rotation have graduated from the Brown GI fellowship program, and 1 has completed the track. Satisfaction with the program is high. Postgraduation survey results show that >80% of graduates who participated in the rotation feel prepared to evaluate and treat GI disorders in pregnancy, and nearly 65% feel prepared to address general GI women's health issues. All respondents report the GI women's health rotation provided training that was otherwise not addressed during fellowship. Conclusions: A training experience in GI women's health can be created using local resources and expertise. Gastroenterologists with this training feel prepared to evaluate and manage the spectrum of women's health issues encountered in practice.

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

“…Two surveys were developed by the study authors: one for PDs and one for RGs. Survey content for both surveys was determined based on (1) the epidemiology of presenting complaints and disease states that present to US emergency departments, (2) established evidence of sex and gender differences in these disease states, (3) the ACGME EM listing of the core content for emergency medicine residency training [ 10 ], and (4) current standards for sex- and gender-based medicine curricula objectives from other fields [ 5 – 8 ]. In developing the survey, as per the National Institutes of Health (NIH), women’s health was defined as pertaining to diseases or conditions unique to, more prevalent in, or more serious in women, including diseases for which manifestations, risk factors, or interventions differ in women [ 11 ].…”

“…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. Though not systematically, there have been small-scale efforts to integrate SGBM into the curricula for Ob-Gyn and Internal Medicine residents [ 5 – 8 ]. 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 ].…”

A blueprint for a new model of sexual and reproductive health care in subspecialty medicine

“…But at present, it is possible for clinicians to enter independent practice without having received much formal reproductive health care training since their ObGyn rotations in medical school. 50 Codevelop CME tailored to subspecialty clinicians across chronic disease states across subspecialty medicine and ObGyn/MFM professional organizations.…”

“…More data are needed to clarify the extent to which SRH is integrated into fellowship training across the medicine subspecialties. But at present, it is possible for clinicians to enter independent practice without having received much formal reproductive health care training since their ObGyn rotations in medical school 50 . Other practitioners who care for patients with chronic medical illnesses, such as advanced practice providers [(APP), e.g., physician assistants and nurse practitioners], may have even fewer training opportunities around SRH.…”

Foundations for a Novel Emergency Medicine Subspecialty: Sex, Gender, and Women's Health

“…18 An initial needs assessment and literature search were conducted followed by a review of guidelines and women's health curricula from other specialties and health professions. [19][20][21][22] Core faculty held informational interviews with content experts and developed educational objectives. For example, faculty met with experts in women's cardiovascular disease to identify how gender can affect the presentation, diagnosis, or treatment of cardiac disease in the ED.…”