Changing Medical Education: Early Efforts to Integrate Women's Health Into Education and Training

Abstract

This is an historical study about the development of women's health curricula in medical education across the U.S. between 1983 and 2004, a period of a great deal of innovation. At that time, some physicians, medical educators, policy makers, and government officials became aware that most U.S. medical school curricula did not address women's health in a comprehensive manner and did not attend to many problems that were the primary causes of mortality and morbidity in women. In addition, medical research and medical education were based on a normative male model. Studies of medical education indicate that medical schools are particularly resistant to changing their curricula. It has been posited that the hidden curriculum makes curricular change difficult. My work addresses how curricular change is possible in relation to women's health. Between 2001 and 2004, I interviewed 29 women's health leaders across the U.S. about their efforts to create women's health programs and curricula, encompassing undergraduate, graduate, and continuing medical education. The empirical issues that I address are: how my respondents became aware that there were problems in women's health, what they did/created, how they did it, and what type of resistance they encountered. My respondents differed in their understanding about women's health based on their life experiences. They learned about women's healthcare and implemented that knowledge into their teaching and curricular development and created interdisciplinary curricula. They established their own credibility, the legitimacy of their efforts, and they mobilized resources. They encountered gender based resistance from other individuals and from the system of medical education. My work contributes to our understanding of how curricular change is possible within medical education, especially as it relates to comprehensive women's health issues.