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The Gaps · Education
The Education Gap
The science most health professionals, physicians, nurses, dentists, physical therapists, are trained on was built predominantly around male physiology. Sex-based differences in how bodies actually function are real, documented, and largely absent from that default curriculum.
what the effect is
Women are 50% more likely than men to receive an incorrect initial diagnosis after a heart attack (59% for STEMI, 41% for NSTEMI), largely because atypical presentation isn’t what clinicians are trained to expect. Verified against the University of Leeds/British Heart Foundation source: 564,412 UK patients over 9 years via the MINAP registry, published 2016; misdiagnosed patients of either sex faced a 70% higher risk of death within 30 days. The pattern isn’t limited to one condition: across hundreds of diseases, women are diagnosed on average about 4 years later than men for the same condition (2.5 years later for cancers, 4.5 years later for metabolic disease), per a 6.9-million-person Danish registry study (Westergaard et al., Nature Communications, 2019). Endometriosis diagnosis takes close to 7 years on average (University of York, 2024). None of this is a knowledge problem the literature hasn’t solved. It’s three connected problems: a research problem (the underlying evidence base still skews male, as above), a tool problem (diagnostic algorithms, risk scores, and reference ranges built on that same skewed data), and a training problem, the largest of the three, since what’s already known isn’t reliably reaching the people making the diagnosis. This page is scoped to that training problem; it’s the piece the Hub’s Education Providers work can move fastest.
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Source: University of Leeds with the British Heart Foundation, MINAP registry analysis, 2016; Westergaard et al., Nature Communications, 2019; University of York, 2024.
What's still missing
Coverage is uneven, not systematic. Most current curricula and CME activity clusters around menopause. Cardiovascular disease has real programs but nothing as centralized as NAMS; autoimmune conditions and cancer have essentially no comparable education push at all, despite documented, decision-relevant sex differences.
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What exists is built once, not kept current. TTUHSC’s modules cover five conditions; AMWA’s "Did You Know" series has grown to eleven facts over years, not months. Most programs here don’t publish a refresh cadence, so they can lag the newest evidence even on the topics they do cover.
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No single resource spans every condition on one cadence. Each program above covers one institution, one condition, or one audience. Nothing currently offers clinicians a by-condition reference that stays current across every disease area.
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Coverage by profession is even thinner than coverage by condition. Nearly everything above trains physicians. Nursing has one real lead (AWHONN), framed as general women’s health rather than sex-based differences specifically. Dentistry has peer-reviewed literature on sex differences in oral health and drug metabolism but no continuing-education activity built from it at all. Physical therapy hasn’t been scanned for this page yet: an open research item, not a confirmed absence.
How the Compendium fits.
The Compendium isn’t a curriculum, but it can feed the ones above: broad, by-condition coverage at primary-literature depth (named trials and registries, effect sizes, evidence-quality flags), refreshed monthly, reviewed section-by-section by a PhD or clinician. A current source curricula and CME content can draw on as the underlying evidence moves, and a way to make the case, backed by data, for education efforts beyond menopause.
where the gap starts
The underlying science defaults to male physiology. FDA guidance from 1977 excluded women of childbearing potential from early-phase drug trials, and it took the NIH Revitalization Act of 1993, a generation ago, to require NIH-funded trials to include women and analyze sex differences at all. That fix never reached the lab bench: reviewing single-sex studies across 10 biological disciplines, Beery and Zucker (2011, Neuroscience & Biobehavioral Reviews) found a male bias in 8 of 10 fields, worst in neuroscience (5.5 to 1) and pharmacology (5 to 1). Zolpidem (Ambien), approved in 1992 and dosed the same for everyone, wasn't adjusted for women's slower metabolism until 2013, 21 years later. Medical, nursing, dental, and physical therapy curricula are all built from this same evidence base.
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why this is a gap
Even where the sex-based science already exists, it's added to curricula as electives and case studies layered onto an existing core, not built into it. There is no national accreditation requirement, from the LCME for medical schools or any equivalent body for nursing, dentistry, or physical therapy, that mandates the content. The pull instead comes state by state, bill by bill: Maine and New Jersey have enacted clinician-education mandates, three more states have bills in committee, and nearly all of them name one condition, menopause. Everything below in "how it's being filled" exists because an individual institution, society, or advocate decided to build it, not because the system requires it.
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Sources: Maine LD 1079; New Jersey S4147/A5309 (P.L.2025, c.175); Women's Health Hub Policy Tracker.