If Medical Schools Can Make Room for Nutrition, Why Not Women’s Health?

There is a common complaint among medical educators: the medical school curriculum is “too crowded.” New topics keep showing up, but where to put them? As ethics and quality improvement and “shared decision-making” are layered into an already dense program, how can even more be jammed in without a complete redesign of medical training? Genuine concern exists over trading hours focused on the “science” of medicine for those highlighting the “art.”

I get it. My first day of medical school was a crash course in drinking from the firehose of knowledge. Even some 30-odd years ago, the sheer volume of learning forced a mastery of memorization tricks and creative drinking games (Pass the skull! Name the foramen!) to make it from one exam to the next. As a medical educator who has spent the last decade teaching doctors how to teach doctors, “cognitive overload” is a term I use on a regular basis. To many, we have reached a point where medical school has become a giant game of Jenga, with every addition and subtraction threatening to collapse the entire structure.

And yet, when faced with both a carrot and a stick from HHS, more than 50 medical schools (about a quarter of those in the U.S.) have signed on to a federal framework for nutrition education. The schools that chose not to support the new framework cited an already sufficient curriculum and/or a fear of federal interference in those decisions. But the concept for more nutrition education is rooted in a strong argument: diet-related disease drives a huge share of illness. Of course we should be teaching doctors about the role nutrition plays in prevention, treatment, and management of conditions such as type 2 diabetes and cardiovascular disease.

The HHS framework hits many areas that have been recommended for nutrition competency expansion. But then it starts to ski out of bounds. “On-site learning at farms including soil sampling, composting, crop rotation” is one that caught my eye. Is that really necessary for tomorrow’s doctors?

I’m not here to argue for or against incorporating evidence-based nutritional understanding into curricula. What I’m here to raise is something different. If a political push for nutrition education means schools change what they teach, then the curricula are not fixed laws of nature. They change when institutions decide something matters. Even if what “matters” is funding.

Which raises a question: if medical schools can make room for nutrition, why can’t they make room for women’s health?

Women make up over half the population, yet medical schools remain surprisingly slow to equally represent their health in medical education. We all know that women were excluded from clinical trials for years for a variety of reasons, and that error of omission had serious consequences. When 51% of the population experiences symptoms of a myocardial infarction differently than the other 49%, why in the world is their presentation the one labeled “atypical?” Isn’t the symptom profile that affects the 49% the atypical one? The legacy of that exclusion still lingers in how medicine is taught and practiced.

This has given us a system where biological sex differences in disease prevalence, presentation, and management are not given enough emphasis. And that in turn gives us a system where conditions affecting women uniquely, differently, or disproportionally are misunderstood, misdiagnosed, or outright dismissed. These gaps are not simply academic. They shape what physicians recognize, what they miss, and what patients experience in exam rooms across the country.

And then, there’s that old chestnut: menopause. A universal biological transition that half the world will experience if they live long enough. One that shepherds in a sharp rise in cardiovascular risk, bone loss, and years lived in a state of frailty. And yet, it is barely taught. As HHS has pushed for a change in warning labels on hormone therapy for menopausal women, many report struggling to find a clinician who understands how to manage it.

Now that we’ve poked a few holes in the “curriculum is too full” argument, it’s time to make room for women’s health. The nutrition debate proves that “full” is a rather flexible concept.

Medical education has repeatedly adapted when priorities shift. Over the past few decades, schools have successfully integrated genetics, health equity, quality improvement, digital health, and artificial intelligence into already dense programs. Somehow the system survived.

The truth is that curricula expand and evolve when institutions decide a topic is important enough to deserve attention. The nutrition proposal demonstrates just how quickly priorities can shift when funding is attached. Whether that economic incentive is coming from the government, from students choosing where to spend their valuable tuition dollars, or from patients who will settle for nothing less than doctors who are properly trained how to care for them. At some point, the economics of failing to adequately train healthcare professionals on sex differences in medicine is going to come back to bite our academic institutions.

Yes, medical students should learn the basics of nutrition. However, maybe “soil sampling” could be traded for “sex-based pharmacology.” “Personal metabolic optimization” could swap out with “sex-based cardiovascular evaluation.” Instead of “Regenerative agriculture,” how about “osteoporosis prevention and management?” It’s probably easier to prevent bone loss in women than to try and regenerate anything.

It is time to stop treating women’s health as a niche specialty or a topic relegated to a single lecture during an endocrinology unit. It is foundational medical knowledge. This does not require a revolution in medical education or a radically different curriculum. It’s as simple as deciding that the health of half the population is worth its share of lecture time.

The current push for nutrition education has inadvertently exposed a useful truth: When funding is on the table, medical schools can find space in the curriculum. If that’s the case, then perhaps the real question isn’t whether there’s room for women’s health.

It’s why we’ve been pretending there isn’t.

Lara Zibners, MD, MMEd, MBA, is co-founder and chairman of Calla Lily Clinical Care, a British women’s healthcare company transforming drug delivery for women. She is a board-certified pediatric emergency medicine specialist, the national educator for ATLS-UK at the Royal College of Surgeons-England, and adjunct faculty at The Ohio State University College of Medicine teaching an advanced competency in entrepreneurship in women’s health.