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Recommendations

1. Changes in physician education and training should take into account the impact of the changing demographics of the population and recognize the special needs of economically, socially, and culturally excluded populations.

2. Institutions should take actions to ensure that women are full participants in the institutional, community, regional, and national changes that are occurring in health care. Collaborations between existing community and national health care groups and student and faculty organizations may be used to foster this goal.

3. Physicians acting as primary care providers for women should have broad understanding of, competency in, and ongoing education about owmen's health.

4. Academic health centers should evaluate systematically the knowledge base within each of the basic and clinical science disciplines to determine what is being taught concerning gender issues and how new information is being incorporated. This information should be used to help identify deficiencies in the understanding and teaching of women's health issues and to make recommendations for change.

5. Evaluation of student performance related to women's health should include assessment criteria to identify and correct deficiencies in knowledge, clinical management, and women patients.

6. Medical school faculties should develop clinical simulations of the health problems most critical to the comprehensive care of women in all age and racial or ethnic groups. Students should be expected to manage these simulations in accordance with a faulty-derived standard in order to receive a medical or osteopathy degree.

7. The National Board of Medical Examiners should review its three examinations to ensure adequate assessment of competency in the knowledge and skills requisite to providing comprehensive care for women. The subsequent nationwide assessment of knowledge and problem-solving abilities would help medical educators identify the clinical simulations to be included in undergraduate medical education.

8. The education of physicians should prepare them to recognize and respond appropriately to the effects of the changing roles of women with regard to their relationships to the medical system, patterns of acquiring health care, access to care, methods of communication, and compliance with treatment and medical advice.

9. Accreditation bodies - the Liaison Committee on Medical Education, the Accreditation Council for Graduate Medical Education, and the American Osteopathic Association - and other national organizations with major involvement in undergraduate, graduate, and continuing medical education - the Association of American Medical Colleges, the Association of American Colleges of Osteopathic Medicine, the American Medical Association, the National Board of Medical Specialties, the National Board of Medical Examiners, the Federation of State Medical Boards, and the Council of Medical Specialty Societies - should collaborate in furthering the development of educational programs that address issues of women's health at all educational levels.

10. Continuing medical education should provide opportunities for practicing physicians to remedy any deficiencies in their knowledge and practices with respect to women's health issues.

11. Fundamental changes that cross traditional departmental boundaries in medical school and postgraduate curricula are needed. Such changes would be facilitated by collaborative centers or programs in women's health within academic health centers.

12. Medical schools and other teaching institutions should develop innovative approaches to medical education and training in women's health that cross traditional institutional boundaries; that facilitate the development of integrated curricula interdisciplinary research, and more responsive clinical models; and that support the development of expert faculty committed to advancing women's health at all levels.

13. Congress should provide funding for competitive grants to support and stimulate women's health initiatives within academic institutions. The programs could include interdisciplinary educational offerings, research, health promotion and disease prevention, and patient care. Such grants should acknowledge programs on the basis of their innovation, their potential to be models for new programs, and their cost effectiveness. These initiatives would facilitate the development of more efficient and responsive clinical models, integrated curricula, and interdisciplinary research in women's health.

14. Congress should establish academic awards in women's health. Such grants should provide support of individual faculty member for their professional development and for the implementation of innovative programs in women's health. Congress should provide funding for competitive grants to support and stimulate academic institutions' efforts at improving women's health.

15. Interdisciplinary fellowship programs in women's health should be established to allow physicians to acquire additional skills and training in the comprehensive care of women and gender-relevant research. Although the programs would vary in emphasis and design, depending on the characteristics of participating institutions, each would have a core program that would introduce fellows to basic principles and knowledge essential to an integrated understanding of women's health and to the scientific methods used in women's health research.

16. Current and expanded efforts to promote researching women's health should be supported.

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