Evidence-based Clinical Practices: a workshop for increasing gender-sensitivity, Nov 24-25

CEHAT, in collaboration with DMER(Directorate of Medical Education and Research), KEM (King Edward Memorial Hospital) and the UNFPA (United Nations Population Fund) conducted ‘Evidence-based Clinical Practices’, a 1.5-day workshop aimed at increasing gender-sensitivity in the medical curriculum. The workshop was attended by mid to senior level medical practitioners and professors from all over Maharashtra.

On the first day, Anuja Gulati from the UNFPA spoke about how violence is a public healthcare issue, and gender bias within the curriculum adversely affects the patients. UNFPA’s Diego Palacio spoke about India’s human rights and health records, and emphasized on the need to understand the needs of the people while imparting healthcare.

Dr Shingare, Director of DMER, then demonstrated the differences in healthcare access between men, women, transgenders and intersex individuals. He said that the gender lens was missing from textbooks, and some literature often showed an open bias against women. “Student doctors learn from teachers, or from observing senior doctors. That is why training them to see gender disparity is most important,” he said. Dr Shingare then inaugurated gender-integrated educational modules on the topics of Forensics and Toxicology, Medicine, Obstetrics and Gynaecology, Preventive and Social Medicine, and Psychiatry. He said that the integration would begin with government medical colleges, and private institutions would be targeted later.

Dr. Priya Prabhu laid the context by speaking of the pilot research and survey of changes in attitudes of students before and after studying gender-integrated modules. She also traced the influence of patriarchy that a child faces since birth, which affects every aspect of life.

Each participant was then asked to share any gender-sensitive practice that they may have undertaken at their place of work. One of the doctors said husbands should be made to play an active role in antenatal care. Another participant mentioned that relatives are at times reluctant to donate blood for the treatment of infant females. The doctors of that hospital donated blood themselves when such an occasion arose.

Dr. Kamakshi Bhate and Dr. Kirti Iyengar conducted sessions on the importance of gender sensitivity among doctors. Dr. Iyengar went through case studies with the participants to understand their methods of conducting diagnosis and respecting consent in course of the doctor-patient interaction.

The first day was concluded with a session by Dr. Sanjay Nagral on ethical conduct and accountability of the doctor towards the patient. He reiterated the need to be ethical in medical practice, given the amount of trust the patient has in the doctor, even though contemporary society may not give prominence to ethics. Many doctors opined that ethics played an important role in medical care, and that modification was required towards western standards since our social structure is quite different to the west. Dr. Nagral also discussed the importance a doctor’s obligation to the patient. He presented a case study to the participants of a patient whose relatives wish to hide his illness from him to protect his mental wellness. The discussion reached the conclusion that a doctor should inform the patient about his own diagnosis, but may choose to hide survival statistics or other information that may upset the patient.

The second day was started by Dr. Sonali Deshpande, who gave guidance on how to provide respectful maternity care. Participants also engaged in a pro-life vs pro-choice debate. This was followed by Dr Jagadeesh Reddy’s session on how doctors should deal with survivors of domestic abuse whom they may encounter. The talk also included legal obligations and rights of doctors and the need to have scientific temperament and a therapeutic role.

All the talks were full of lively discussions about patient-doctor interactions as well as workplace disparity between male and female doctors.

Maharashtra would be the first state to include a gender-integrated module into its medical curriculum. This approach is expected to help not only the healthcare providers in carrying out their duties, but also work towards eliminating gender disparities in health as well as providing a support system to victims of gender-based violence.