Needs Assessment
Women's health competencies in the undergraduate psychiatry curriculum: Past and future☆,☆☆

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Abstract

Objective: To review the current psychiatry model clerkship objectives for their inclusion of women's health competencies and advise changes in light of recommendations of psychiatric educators and those developed at the Association of Professors of Gynecology and Obstetrics (APGO) Women's Health Education Retreat 2000. Study Design: The clerkship objectives promulgated by the Association of Directors of Medical Student Education in Psychiatry (ADMSEP) were reviewed for their relevance to women's health. ADMSEP members were surveyed at their 1997 annual meeting and again by means of their listserve in 2000 for opinions regarding inclusion of women's health topics in their curricula. Results: The current objectives imply many women's health competencies. Those pertaining to abuse are particularly comprehensive. Survey data suggest that educators perceive that psychiatric aspects of reproductive functioning, violence, and trauma; gender differences in prevalence, presentation, and treatment of psychiatric disorders; and gender aspects of the doctor-patient relationship merit particular emphasis in the clerkship curriculum. Conclusions: Women's health competencies are broadly but implicitly represented in the psychiatry clerkship objectives as currently formulated. Revisions should encompass more explicit appreciation of gender differences and specific additional knowledge, skills, and attitudes. (Am J Obstet Gynecol 2002;187:S15-8.)

Section snippets

Materials and methods

In 1996-1997 the authors undertook a comprehensive review of the ADMSEP psychiatry clerkship objectives to determine their inclusiveness and relevance to the women's health competencies being developed by an interdisciplinary group of educators under the leadership of APGO, the National Academy of Women's Health Medical Education (NAWHME), and the Alliance for Clinical Education (ACE), of which ADMSEP is a constituent organization. Objectives were designated as relevant to women's health if

Results

Review and analysis of the psychiatry clerkship objectives yielded several conclusions. First, by virtue of their orientation toward the generalist practitioner, the objectives intrinsically address women's health widely but not explicitly. For instance, because women are far more likely than men to seek psychiatric care in the generalist sector, improvements in interviewing methods, diagnosis, and treatment of psychiatric disorders in that sector disproportionately affect women. In addition,

Comment

The term women's health conflates 3 related but separable concepts, which would benefit by being considered discretely for the purpose of appreciating their heuristic value. First, gender is an important, indeed basic, category to account for in all aspects of medical practice. Students must learn habitually to consider the effects of gender in any decisions regarding diagnosis and treatment, even if our knowledge is at present incomplete. If the importance of gender were widely appreciated in

Acknowledgements

We acknowledge the assistance of Irwin Hassenfeld, MD, and Anthony Rostain, MD, in the preparation and execution of the 1997 workshop on women's health in psychiatric education.

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☆

Portions of this paper were presented at the APGO Women's Health Education Retreat 2000, Chantilly, Va, November 10-12, 2000.

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Reprint requests: Amy C. Brodkey, MD, Friends Hospital, 4641 Roosevelt Blvd, Philadelphia, PA 19124-2399.

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