Auditing sex- and gender-based medicine (SGBM) content in medical school curriculum: a student scholar model

Abstract

Background: Sex- and gender-based medicine (SGBM) aims to (1) delineate and investigate sex- and gender-based differences in health, disease, and response to treatment and (2) apply that knowledge to clinical care to improve the health of both women and men. However, the integration of SGBM into medical school curricula is often haphazard and poorly defined; schools often do not know the current status of SGBM content in their curricula, even if they are committed to addressing gaps and improving SGBM delivery. Therefore, complete auditing and accounting of SGBM content in the existing medical school curriculum is necessary to determine the baseline status and prepare for successful integration of SGBM content into that curriculum.

Methods: A review of course syllabi and lecture objectives as well as a targeted data analysis of the Curriculum Management and Information Tool (CurrMIT) were completed prior to a real-time curriculum audit. Subsequently, six "student scholars," three first-year and three second-year medical students, were recruited and trained to audit the first 2 years of the medical school curriculum for SGBM content, thus completing an audit for both of the pre-clinical years simultaneously. A qualitative analysis and a post-audit comparative analysis were completed to assess the level of SGBM instruction at our institution.

Results: The review of syllabi and the CurrMIT data analysis did not generate a meaningful catalogue of SGBM content in the curriculum; most of the content identified specifically targeted women's or men's health topics and not sex- or gender-based differences. The real-time student audit of the existing curriculum at Texas Tech revealed that most of the SGBM material was focused on the physiological/anatomical sex differences or gender differences in disease prevalence, with minimal coverage of sex- or gender-based differences in diagnosis, prognosis, treatment, and outcomes.

Conclusions: The real-time student scholar audit was effective in identifying SGBM content in the existing medical school curriculum that was not possible with a retrospective review of course syllabi and lecture objectives or curriculum databases such as the CurrMIT. The audit results revealed the need for improved efforts to teach SGBM topics in our school's pre-clinical curriculum.

Keywords: Medical school curriculum evaluation; SGBM curriculum integration; Sex- and gender-based medicine (SGBM).

Fig. 1

SGBM content versus male or female sex-specific health content

Fig. 2

Existing curriculum at the TTUHSC SOM at the time of student scholar audit

Fig. 3

SGBM competencies covered (first-year courses). COA clinically oriented anatomy, BCT biology of cells, SFMOS structure and function of major organ systems, HD host defense, ECE I early clinical experiences I

Fig. 4

SGBM competencies covered (second-year courses). GPIN general principles of integrated neuroscience, MS multi-system disorders, SD I, system disorder I, SD II system disorder II, ECE II early clinical experiences II