Meeting the need for women's health training in gastroenterology: creation of a women's digestive disorders program at Brown University

Need for Awareness and Training in Women's Gastrointestinal Health: A Call to Action

Women's gastrointestinal (GI) health is a topic that is not well understood nor taught in most training programs. In this article, we highlight the importance of proper training in women's GI health among gastroenterologists and fellows, and identify some common conditions to provide the best possible treatment for their female patients.

Contraceptive Considerations for Women with Gastrointestinal Disorders

Gastroenterologists are in a unique position to assist women with chronic gastrointestinal disorders in order to optimize their health prior to pregnancy. Women, whether with chronic conditions or not, and their infants are more likely to be healthy when pregnancies are planned. Achieving a planned pregnancy at the ideal time or preventing pregnancy altogether requires the use of appropriate contraceptives. There is a broad range of contraceptives available to women in the USA, and the majority of women with digestive diseases will be candidates for all effective methods. Guidance from the Centers for Disease Control and Prevention aids clinicians in prescribing appropriate contraceptives to women with medical disorders. This review will focus on contraception for women with inflammatory bowel disease and chronic liver disease, including liver transplant.

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

BACKGROUND

Sex 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.

METHODS

Two 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.

RESULTS

43.2 % 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.

CONCLUSIONS

Over 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.

Foundations for a novel emergency medicine subspecialty: sex, gender, and women's health

Sex and gender affect all aspects of health and disease, including pathophysiology, epidemiology, presentation, treatment, and outcomes. Sex- and gender-specific medicine (SGM) is a rapidly developing field rooted in women's health; however, inclusion of SGM in emergency medicine (EM) is currently lacking. Incorporating principles of sex, gender, and women's health into emergency care and training curricula is an important first step toward establishing a novel subspecialty. EM is an ideal specialty to cultivate this new field because of its broad interdisciplinary nature, increasing numbers of patient visits, and support from academic medical centers to promote expertise in women's health. This article describes methods used to establish a new multidisciplinary training program in sex, gender, and women's health based in a department of EM. Women's health and SGM program initiatives span clinical care, patient education, clinical research, resident and fellow training, and faculty development.