Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2020 Jul 1;23(7):469-479. doi: 10.34172/aim.2020.44.
The aim of this paper is to present a synthesis of solutions for post-graduate medical education (PGME) and the health-care system in addressing challenges in relation to women's health.
A critical review was conducted within three themes: women's health status, women's preferences for female physicians, and women in surgery. The study was conducted in two phases that consisted of an analysis of the trends of Iranian women's health and women's participation in PGME since 1979 followed by a thematic analysis to assess the current challenges and their implications on medical education.
Our analysis revealed important trends and challenges. Since 1979, life expectancy has increased by 29% in Iranian women, while female adult mortality rate has decreased by 78%, and maternal mortality rate has decreased by 80%. The number of female medical specialists has increased by 933% , while the number of female subspecialists has increased by 1700%. According to our review, ten major challenges regarding women's health were identified: 1) Increase in chronic disease; 2) Increase in cancer cases; 3) Preference for same-gender physicians in sensitive procedures; 4) Delayed care-seeking due to lack of female surgeons; 5) Lack of gender-concordance in clinical settings; 6) Underestimating female surgeons' capabilities; 7) Female physicians' work-family conflicts; 8) Male-dominancy in surgical departments; 9) Women's under-representation in higher rank positions; and 10) Lack of women in academic leadership.
We identified different solutions to bridge these gaps. Community-based education, Gender- concordant considerations, and empowering women in surgical departments could help medical education policy makers to address the challenges.
本文旨在综合探讨医学研究生教育（PGME）和医疗体系在解决与妇女健康相关挑战方面的解决方案。
我们在三个主题内进行了批判性回顾：妇女健康状况、妇女对女医生的偏好以及外科手术中的妇女。该研究分为两个阶段进行，第一阶段分析了自 1979 年以来伊朗妇女健康和妇女参与 PGME 的趋势，第二阶段通过专题分析评估了当前的挑战及其对医学教育的影响。
我们的分析揭示了重要的趋势和挑战。自 1979 年以来，伊朗妇女的预期寿命增加了 29%，而成年女性死亡率下降了 78%，孕产妇死亡率下降了 80%。女性医学专家的数量增加了 933%，而女性亚专科医生的数量增加了 1700%。根据我们的审查，确定了十个与妇女健康相关的主要挑战：1）慢性病增加；2）癌症病例增加；3）在敏感程序中偏好同性别医生；4）由于缺乏女外科医生，就诊时间延迟；5）临床环境中缺乏性别一致性；6）低估女外科医生的能力；7）女医生的工作-家庭冲突；8）外科部门男性主导；9）女性在高级职位中的代表性不足；以及 10）学术领导层中缺乏女性。
我们确定了不同的解决方案来弥合这些差距。基于社区的教育、性别一致性考虑以及增强外科部门的妇女权能，可以帮助医学教育政策制定者应对这些挑战。
