1. Sex, Gender and Medicine Semester 3 Seminar, 2004 Ann-Maree Nobelius, CMHSE, Faculty of Medicine Nursing and Health Sciences Monash University Australia

2. To tell or not to tell….

3. I SAY TELL!

4. Mainstreaming a Gender Perspective into Medicine ‘Mainstreaming’ simply means that a concept (or process) be fully integrated into all institutional processes so that it becomes a ‘mainstream’, common or everyday concept. ‘Mainstreaming’ simply means that a concept (or process) be fully integrated into all institutional processes so that it becomes a ‘mainstream’, common or everyday concept. Making gender concepts more ‘mainstream’, common or everyday within medical education and practice Making gender concepts more ‘mainstream’, common or everyday within medical education and practice Practically it means acknowledging where difference is important throughout the entire curriculum and teaching process, in clinical practice and in policy development, and providing balance where needed. Practically it means acknowledging where difference is important throughout the entire curriculum and teaching process, in clinical practice and in policy development, and providing balance where needed.

5. Mainstreaming Gender the process must be evidence based and balanced the process must be evidence based and balanced men have gender issues too men have gender issues too the process slow to come to medicine but common in government, NGO and trans- national institutions worldwide the process slow to come to medicine but common in government, NGO and trans- national institutions worldwide parts of the process have been undertaken at other universities medical schools parts of the process have been undertaken at other universities medical schools

6. Teaching Gender as a Women’s Health Subject USA (4) Columbia* Columbia* Harvard Harvard Minnesota Minnesota Cincinnati Cincinnati Sweden (4) Karolinska Karolinska Likoping Likoping Uppsala Uppsala Lund Lund

7. Mainstreaming Gender (stared as women’s only now gender) Canada (5) University of Western Ontario University of Western Ontario McMaster University McMaster University University of Toronto University of Toronto Queen’s University, University of Ottawa Queen’s University, University of Ottawa Northern Ontario Medical School Northern Ontario Medical School

8. Evidence-based Gender Mainstreaming We are doing it! We are doing it! Year 1 & 2 Year 1 & 2 Year 3 Year 3 Year 4 & 5 Year 4 & 5 ASSESSMENT!!! ASSESSMENT!!! Post Graduate Post Graduate Guides, International Conferences and Publications coming up Guides, International Conferences and Publications coming up Monash leads mainstreaming in med ed Monash leads mainstreaming in med ed Working on Clinical Practice Working on Clinical Practice

9. Students can get involved Selectives and BMedSci being developed so that students can graduate with publications that are international best practice in gender-specific medicine Selectives and BMedSci being developed so that students can graduate with publications that are international best practice in gender-specific medicine You can define the field You can define the field

10. What about Monash staff? We are starting training (tutor guide) We are starting training (tutor guide) Haven’t got to all of the clinical schools yet (literally 1,000 of people) Haven’t got to all of the clinical schools yet (literally 1,000 of people) We started at the top We started at the top

11. These are the people we did get to! The VC The VC Prof Edward Byrne, the dean Prof Edward Byrne, the dean Prof Leon Piterman, deputy dean Prof Leon Piterman, deputy dean Profs Richard Doherty and Chris Browne, co-chairs of the curriculum committee Profs Richard Doherty and Chris Browne, co-chairs of the curriculum committee Prof Brian Jolly, head of medical education Prof Brian Jolly, head of medical education Prof Julian Smith, Head of Surgery @ MMC Prof Julian Smith, Head of Surgery @ MMC Prof Susan Phillips, Chair Ontario C Med Schools Prof Susan Phillips, Chair Ontario C Med Schools

12. Dr Jane Fox, Surgeon @ MMC Dr Jane Fox, Surgeon @ MMC Dr Jan Coles, Dept GP Dr Jan Coles, Dept GP Assoc. Prof Rob McLachlan, Andrology Assoc. Prof Rob McLachlan, Andrology Prof Jayashri Kulkarni, head of Psychiatry @ Alfred Prof Jayashri Kulkarni, head of Psychiatry @ Alfred Dr Chris Wright, Head of ICU @ MMC Dr Chris Wright, Head of ICU @ MMC PCL tutors PCL tutors Anatomy Demonstrators Anatomy Demonstrators

13. Because this is an emerging field… The evidence is new and emerging The evidence is new and emerging You will come across people who wont have a clue what you’re asking You will come across people who wont have a clue what you’re asking You will come across people who will try to tell you that your question is irrelevant You will come across people who will try to tell you that your question is irrelevant People may know the answer or actually practice in a gender specific way, but don’t understand the question because they have never been asked to think about it in that way People may know the answer or actually practice in a gender specific way, but don’t understand the question because they have never been asked to think about it in that way It’s very common in medicine to speak about ‘the patient’ rather than think specifically about male of female patients It’s very common in medicine to speak about ‘the patient’ rather than think specifically about male of female patients

14. If you don’t get the answers you need … Places to find info about difference: Columbia University’s Journal of Gender Specific Medicine www.mmhc.com/jgsm/ Monash University’s Gendermed website www.med.monash.edu.au/mrh/gendermed/ Or ask any of the specialists you saw on the previous list, because they get it! www.andrologyaustralia.org

15. Along with regular critical literature review skills think about gender Does the disease affect both men and women? Does the disease affect both men and women? Were both men and women included in the study? If not, why not? Were both men and women included in the study? If not, why not? Is the data presented in a sex disaggregated way? Is the data presented in a sex disaggregated way? Understand that if both men and women are not reported on that the evidence may only tell part of the story and further evidence should be sought Understand that if both men and women are not reported on that the evidence may only tell part of the story and further evidence should be sought

16. Two simple questions about gender How would this scenario be different if the players were male/female? How would this scenario be different if the players were male/female? Would this scenario seem reasonable if the players were male/female Would this scenario seem reasonable if the players were male/female

17. How would this presentation be different if the patient were male/female? How would the treatment be different if the patient were male/female? How would the outcomes be different if the patient were male/female? How would the consultation be different if the doctor were male/female?

18. Sorry, this group got the rough end of the stick A guide for you by next semester A guide for you by next semester Apologies from the Faculty Apologies from the Faculty What I will do to make it up to you What I will do to make it up to you  Video screening  Exam material  Sneak peek at Year 3

19. …and when it comes to your medical education Be critical, don’t just accept Be critical, don’t just accept Be inquiring, if you don’t get it, ask Be inquiring, if you don’t get it, ask Don’t let ‘the blokes in suits’ make you feel bad Don’t let ‘the blokes in suits’ make you feel bad There are plenty of good guys to help you out! There are plenty of good guys to help you out!