BACKGROUND:Women's health (WH) is recognized as a core competency in internal medicine (IM) residency programs, yet residents report inadequate training and low comfort across WH topics. Some IM residencies have established tracks to meet this need, but no comprehensive review of their implementation and structure exists. We describe the current state and best practices for WH tracks in IM residency programs. METHODS:We reviewed current WH tracks within U.S. categorical IM residency programs. Program websites were reviewed for information on leadership, clinical focus, and requirements. Track leaders were contacted for verification and additional information. Four well-established tracks were selected as case studies. RESULTS:There are 12 WH tracks in IM residencies. Key common elements among successful tracks include regular educational sessions, dedicated clinical training blocks, at least two core WH practicing general IM faculty, faculty salary support, and administrative support. Clinical training blocks consistently include focused primary care experiences and subspecialist clinical partnerships. Educational activities often include both faculty- and resident-led sessions. Resident participation ranges from 0 to 8 per postgraduate year. Successful tracks cultivate community through social events and mentorship. Challenges include financial and administrative support and recruiting and retaining core faculty. CONCLUSIONS:WH tracks offer a solution to IM training limitations. Successful tracks are characterized by consistent clinical training, didactic education, and mentorship. They effectively build community, establish robust primary care training, support residents across various career interests, and cultivate strong faculty teams and subspecialist partnerships. Dedicated faculty time and administrative support are key to sustained success and growth.
INTRODUCTION:The 2022 U.S. Supreme Court decision in Dobbs v. Jackson Women's Health Organization eliminated federal abortion protections, delegating abortion law to individual states and complicating access to reproductive health care. This study examines trends in female permanent contraception before and after Dobbs within a large academic health system in a state with abortion-protective legislation following the ruling. METHODS:We conducted a retrospective analysis of permanent contraception procedures from July 2021 to June 2022 (pre-Dobbs) and July 2022 to June 2023 (post-Dobbs) in a Northeastern U.S. health system. Linear regression modeling assessed changes in procedure volume overall and by demographic factors for each 12-month period, including a test of difference between periods. RESULTS:We included 1,115 procedures. Procedure volume did not demonstrate significant slopes in either period, nor differed between periods. However, among publicly insured patients, permanent contraception declined pre-Dobbs (β = -0.90, p = 0.04), increased post-Dobbs (β = 1.19, p = 0.03), and differed between periods (p < 0.01). Permanent contraception in Hispanic patients increased post-Dobbs (β = 1.01, p < 0.02) with a significant difference between periods (p < 0.02). Patients identifying as "other" race demonstrated similar patterns as Hispanic patients. For the overall cohort, no significant changes were observed between periods by age, postpartum status, or hospital site. CONCLUSION:Post-Dobbs, permanent contraception remained stable in our health system overall. The increase in permanent contraception among publicly insured and Hispanic patients suggests that factors beyond state-level abortion protections shape decisions regarding permanent contraception. Further research is required to better characterize the effects of reproductive policy changes on patient decision-making and long-term access to reproductive health care.
BACKGROUND:Experiencing intimate partner violence (IPV) before or during pregnancy is associated with poor pregnancy and birth outcomes. Less is known about the effects of IPV before pregnancy on preconception health and health care. METHODS:We analyzed 2016-2022 data from the Pregnancy Risk Assessment Monitoring System, a population-based surveillance system that collects information about experiences around the time of pregnancy among women with a recent live birth. We estimated, separately, the prevalence of physical and emotional IPV in the 12 months before pregnancy and examined associations with preconception experiences using multivariable logistic regression. RESULTS:Compared with not experiencing the specific type of IPV, experiencing physical or emotional IPV in the 12 months before pregnancy was associated with higher odds of having a prepregnancy health care visit for depression or anxiety (adjusted odds ratio [aOR], 95% confidence interval [CI] physical: 2.73, 2.45-3.06; emotional: 3.17, 2.29-4.41) or for an illness or chronic condition (aOR, 95% CI physical: 1.54, 1.37-1.74; emotional: 2.04, 1.48-2.81). Both IPV types were associated with more than three times the odds of depression, anxiety, and cigarette smoking in the 3 months before pregnancy. Over half of women who experienced physical or emotional IPV in the 12 months before pregnancy subsequently experienced physical or emotional IPV during their pregnancy. CONCLUSION:Preventing IPV before pregnancy, through primary prevention and screening with referrals as part of preconception or routine health care, is an important strategy to reduce violence against women and improve maternal and infant health.
OBJECTIVE:To examine how abortion policy environments and geographic context are associated with reproductive health outcomes, and to characterize implications for obstetrics and gynecology (OBGYN) care. METHODS:We conducted a cross-sectional analysis exploring associations between outcomes of health care quality and access ranked in the 2024 Commonwealth Fund State Scorecard to Guttmacher abortion policy categories (restrictive, middle-ground, and protective) and U.S. Census regions. Kruskal-Wallis rank-sum tests with Dunn post hoc comparisons and Spearman correlations assessed the relationship of these environmental factors with 32 outcomes. RESULTS:Southern states had worse overall reproductive health rankings than other regions (p < 0.001). Restrictive abortion policy states had poorer outcomes across all domains of OBGYN care and access (p < 0.01). Higher rural population correlated with higher infant mortality (r = 0.31, p = 0.028), preterm birth (r = 0.36, p = 0.010), depression before/during pregnancy (r = 0.71, p < 0.001), and poor mental health (r = 0.44, p = 0.001). CONCLUSIONS:Health disparities associated with restrictive abortion policies and geographic inequities signal regional variation in OBGYN workforce strain, reinforcing the need for systems-level, context-aware strategies to support retention and sustainability.
BACKGROUND:Sex and gender differences substantially influence the epidemiology, clinical presentation, and outcomes of type 2 diabetes (T2D). Although guideline-recommended cardiometabolic therapies have expanded in recent years, evidence suggests that women with T2D continue to experience disparities in risk factor control, access to cardioprotective treatments, and clinical outcomes. This study aimed to evaluate sex-based differences in quality of care, treatment patterns, and clinical inertia using real-world data from the Associazione Medici Diabetologi (AMD) Annals Initiative. METHODS:We conducted a cross-sectional analysis of 2023 data from 296 diabetes clinics participating in the AMD Annals registry. Adults with active T2D (≥1 antidiabetic prescription and ≥1 clinical assessment in 2023) were included. Process indicators, intermediate outcomes, pharmacologic treatments, and final outcomes were assessed according to AMD Indicators (Revision 9). All analyses were stratified by sex. RESULTS:The study included 571,962 individuals with T2D (41.5% women). Glycemic control and overall quality-of-care scores were similar between sexes. However, women exhibited higher BMI, greater prevalence of severe obesity, poorer lipid control, and higher rates of reduced eGFR. Despite comparable or higher cardiometabolic risk, women were less frequently monitored for albuminuria and retinopathy and were significantly less likely to receive SGLT2 inhibitors and GLP-1 receptor agonists, particularly in the presence of chronic kidney disease, cardiovascular disease, or heart failure. Indicators of clinical inertia consistently disadvantaged women, especially regarding cardioprotective therapies. CONCLUSIONS:Despite comparable overall quality-of-care scores, clinically meaningful sex disparities persist in T2D management in Italy. Women experience a higher burden of metabolic risk and reduced access to evidence-based cardioprotective treatments. These findings highlight the urgent need for gender-sensitive diabetes care strategies to reduce therapeutic inequities and improve cardiovascular and renal outcomes in women with T2D.
BACKGROUND:Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that increases the risk of emphysema and chronic obstructive pulmonary disease (COPD). Increased intra-abdominal pressure associated with chronic cough and damage to connective tissues that support pelvic organs suggest an association between COPD and pelvic organ prolapse (POP), a condition with estimated population prevalence of 3-6%. This study examined the prevalence of symptomatic POP among women with AATD. METHODS:Women ≥18 years with AATD were invited to participate in a survey in 2025. The Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) assessed POP. Data were linked to previous survey responses including age, AATD genotype, the Chronic Airways Assessment Test (CAAT), body mass index, smoking, employment, lung disease, alpha-1 antitrypsin augmentation prescribed, and sleep apnea. Dichotomized POPDI-6 scores (>17 versus ≤17) were assessed by participant characteristics using chi-squared tests, Fisher's exact tests, Wilcoxon-Mann-Whitney tests, and logistic regression. RESULTS:Of those invited to participate, 921 (36.1%) individuals completed the survey. POPDI-6 scores (n = 917) were right-skewed, and 22.1% reported significant symptom distress (POPDI-6 > 17). There were significant differences in dichotomized POPDI-6 scores by age, sleep apnea, hysterectomy, surgery, number of vaginal births, and AATD genotype. Women with POPDI-6 >17 had higher overall and cough CAAT scores than those ≤17. No significant differences emerged for other characteristics. In adjusted logistic regression, there were increased odds of POPDI-6 >17 with three or more vaginal births, a diagnosis of sleep apnea, increasing CAAT score, and a genotype of MZ, but decreased odds of POPDI-6 >17 with increasing age. CONCLUSIONS:The prevalence of POP among women with AATD was higher than that estimated in the general population. Further studies are warranted to confirm this observation. Screening of women with AATD for POP may be an opportunity to identify needs for pelvic floor therapy and education.
Background: Endometriosis affects 10% of reproductive-aged women globally and is one of the major causes of infertility. It is a debilitating, chronic condition with an average diagnostic delay of up to 10 years. This is partly due to the lack of noninvasive tools to diagnose the disease, leading to disease progression and poor health-related outcomes.Aim: The purpose of this scoping review was to synthesize the available literature on the existing tools, their use and applicability, and identify current gaps in the field.Method: A comprehensive search was conducted to identify applicable studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews guidelines.Results: Eighteen studies were included in the review, with screening tools classified into four categories: questionnaire-based, app-based, machine learning and artificial intelligence (AI)-driven, and subtype-focused models. Among the included study tools, 14 reported on psychometric parameters with area under the receiver operating characteristic curve values ranging from 0.77 to 0.95, with machine learning and AI-driven models reporting the highest accuracy metrics.Conclusion: Significant gaps were noted across identified tools, particularly in external validation, comprehensive psychometric evaluation, and cultural adaptation.
BACKGROUND:Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) offer important cardiovascular-kidney-metabolic benefits to women with type 2 diabetes (T2D) but are contraindicated during pregnancy. We sought to describe the frequency of GLP-1 RA prescribing among young women with T2D and to examine pregnancy intention, contraceptive use, and receipt of reproductive health counseling in this population. METHODS:A total of 382 English- and Spanish-speaking women with T2D, aged 18-44, were recruited from 38 health centers in Chicago. Patients were enrolled in the usual care arm of an ongoing clinical trial testing a preconception health intervention. GLP-1 RA prescribing was determined via self-report with chart verification. Bilingual research coordinators administered structured surveys measuring pregnancy intention, contraceptive use, and receipt of reproductive health counseling. RESULTS:Participants were sociodemographically diverse; 42.5% had a household income less than $35,000/year, 46% had limited health literacy, and the average age was 36 years. Half (50.8%) were prescribed a GLP-1 RA. Among women prescribed GLP-1 RAs (n = 194), 54.6% intended a future pregnancy; 40.7% used hormonal contraceptives or an intrauterine device. Few reported discussing pregnancy intention (11.9%), contraceptive use (11.4%), or preconception health (13.4%) during their recent visit. Women with limited health literacy were less likely to report discussing preconception health (6.3%, 95% confidence interval [CI]: 1.4-11.2 versus 18.4%, 95% CI: 12.0-24.9, p = 0.01). CONCLUSION:GLP-1 RAs are commonly prescribed to young women with T2D, many of whom intend a future pregnancy, yet reproductive health counseling is scarce. Optimizing preconception care is critical to improve outcomes, particularly for women with limited health literacy.
BACKGROUND AND OBJECTIVES:Primary tobacco smoke exposure has been associated with poorer bone health in adults; however, there is a dearth of information on such exposure in healthy growing adolescents, a time when a significant percentage of bone mass is acquired. We evaluated the impact of primary and secondary tobacco smoke exposure on bone mass and density across adolescence in females, hypothesizing that an understudied measure of primary and secondary tobacco smoke exposure would provide a more accurate picture of the impact on bone accrual. MATERIALS AND METHODS:In a cohort sequential design, healthy females aged 11-17 years (N = 262) were recruited from a midwestern children's hospital and community to participate in four annual visits. Annual dual energy x-ray absorptiometry measured bone mineral content (BMC) and density (BMD) of the whole body, hip, and lumbar spine. Self-report measures of smoking were collected at annual visits and by phone at 3-month intervals. RESULTS:Cumulative smoke exposure was associated with higher BMC Z-scores at all sites (0.02-0.03, p < 0.01) and Spine BMD scores (0.02, p < 0.05), although effects were small. For hip BMD Z-score, the magnitude of effect of cumulative smoke exposure was greater in younger girls (p = 0.002). CONCLUSION:Unanticipated findings suggest that (1) levels of cumulative smoke exposure, higher than those represented in these data, may be necessary to negatively impact bone health in adolescence, and (2) high bone accrual in early adolescence is robust, regardless of the amount of tobacco smoke exposure. Immediate adverse effects of smoking during early adolescence may not occur, even if lifelong risk is incurred. Future longitudinal studies will be necessary to confirm our findings.
BACKGROUND:While prior research has highlighted the consequences of restrictive reproductive policies on access to care and maternal morbidity, there is limited attention on the potential impact on hypertensive disorders of pregnancy (HDP), a leading contributor to maternal morbidity and mortality. This study examined whether cumulative state-level abortion policy restrictiveness is associated with the odds of HDP among women aged 15-44 in the United States. METHODS:Data from the 2018 and 2021 National Vital Statistics System were linked with state-level abortion laws compiled by the LawAtlas Abortion Law Project. A composite abortion policy index was created using 12 restrictive legal indicators, scored and grouped into tertiles representing low, moderate, and high restrictiveness. The primary outcome was HDP, including gestational hypertension, preeclampsia, and eclampsia. Generalized linear mixed models were used to estimate adjusted odds ratios (aORs) for individual-level and state-level covariates. RESULTS:In 2018, moderate restrictiveness was associated with slightly lower odds of HDP (aOR = 0.89, 95% confidence interval [CI]: 0.79-0.99, p = 0.036), but this association was not observed in 2021. High restrictiveness was not significantly associated with HDP in either year. Strong, consistent predictors of HDP included adolescent and advanced maternal age, preexisting diabetes, obesity, and racial disparities, particularly among Black and Hispanic women. CONCLUSIONS:This study found no consistent link between abortion policy restrictiveness and HDP, with individual-level clinical, demographic, and social factors serving as the strongest predictors. Ongoing monitoring is needed to understand how shifting reproductive health policies intersect with structural inequities to shape maternal outcomes in the United States.
BACKGROUND:Unwanted or mistimed pregnancies are pregnancies that occur in women who do not intend to become pregnant or did not desire another child at the time of conception. Ensuring access to contraception is important for both preventing unwanted pregnancy among active duty service women (ADSW) and preserving their right to reproductive autonomy. Women's Health Clinics (WHCs), available on some installations, bases, or duty stations owned and operated by the United States military, are intended to improve contraceptive access. This study aims to determine the association between availability of WHCs and unwanted pregnancy among ADSW. METHODS:Using data from the 2020 Women's Reproductive Health Survey of ADSW we examined unwanted pregnancy in 2,939 ADSW who reported pregnancy in the last 12 months. Bivariate analyses and weighted binary and multivariable logistic regressions were used to assess the relationship between women reporting an unwanted pregnancy and having a WHC at their installation. RESULTS:We identified 354 unwanted pregnancies. Having a WHC at their current installation was significantly associated with a 39% decreased odds of unwanted pregnancy (aOR = 0.61; 95% CI: 0.42-0.88). CONCLUSIONS:Having a WHC at an ADSW's installation is associated with significantly decreased odds of unwanted pregnancy. This suggests that access to specialty women's health care at duty stations may promote reproductive autonomy among ADSW, contributing to the prevention of unwanted or mistimed pregnancies, ultimately enhancing mission readiness.
BACKGROUND:Despite the health benefits of parental leave (PL), many physicians in the United States take little to no PL. This issue is particularly pressing in academic neurology, which faces high burnout rates and a projected shortage. This study evaluated the impact of PL on career achievements and burnout in academic neurology. METHODS:A cross-sectional survey of neurologists in 19 U.S. institutions measured PL experience, academic achievements, and burnout. Chi-squared test was used to assess for group differences in the two groups: PL/NoPL and in subgroups: men/women. General linear regression models were used to examine the association between PL, gender, achievements, and burnout. RESULTS:Among 239 respondents with children, 74.8% of women and 28.6% of men took PL (87.9% of women and 97.3% of men took less than 6 weeks). Academic achievement measures were similar for those who took PL and those who did not (NoPL) with the exception of fewer awards in the PL group (mean 2.25 for PL and 6.21 for NoPL, p = 0.018). The PL group showed higher family-work conflict score (PL-score = 22.64, NoPL-score = 18.27, p < 0.001) and higher emotional exhaustion (PL 43.2%, NoPL 34.6%, p = 0.017) than the NoPL group. Emotional exhaustion was higher in women compared with men, despite higher weekly work hours in the PL group men (p = 0.021). CONCLUSION:Faculty who took PL did not have worse academic productivity compared with NoPL. But the PL group had higher levels of burnout and emotional exhaustion, especially in women, highlighting the need for support during and when returning from PL.
Genitourinary syndrome of menopause (GSM) is a chronic, progressive condition resulting from estrogen and androgen deficiency that affects 27-84% of postmenopausal individuals. Symptoms include vaginal dryness, dyspareunia, urinary urgency, dysuria, and recurrent urinary tract infections. Despite strong evidence supporting the safety and efficacy of local vaginal estrogen (VE) therapy, treatment remains underutilized due to clinician uncertainty, misconceptions regarding systemic risk, and regulatory warnings. Recent clinical guidelines emphasize vaginal hormones as first-line therapy for GSM. This review summarizes the pathophysiology of GSM, evidence supporting local hormone therapy, safety considerations, and practical prescribing strategies for clinicians. Pearls for clinical practice are discussed, including dosing regimens, formulation selection, patient counseling, and strategies to overcome barriers to treatment adherence.
BACKGROUND:Polycystic ovary syndrome (PCOS) has been associated with adverse pregnancy outcomes, although reported risks vary across studies. Metabolic heterogeneity within PCOS may contribute to this variability. Dysglycemia during pregnancy may identify a subgroup at increased obstetric risk. The study aims to evaluate whether dysglycemia is associated with preeclampsia and other adverse pregnancy outcomes among individuals with PCOS. METHODS:We performed a secondary analysis of the prospective Fatty Liver in Pregnancy (FLIP) cohort (n = 1,321). PCOS was defined by chart review of the electronic health record. Dysglycemia was defined as current or prior gestational diabetes, abnormal glucose tolerance testing, hemoglobin A1c > 5.7% during pregnancy, or pregestational diabetes. Participants were categorized as PCOS with dysglycemia (n = 36), PCOS without dysglycemia (n = 44), or non-PCOS controls (n = 1,238). The primary outcome was preeclampsia. Secondary outcomes included gestational hypertension, preterm birth, abnormal neonatal weight, and neonatal hypoglycemia. Multivariable logistic regression adjusted for maternal age and body mass index. RESULTS:Among 80 individuals with PCOS, 45% had evidence of dysglycemia. Preeclampsia occurred in 33% of those with PCOS and dysglycemia, 7% of those with PCOS without dysglycemia, and 12% of controls (p = 0.005 for PCOS with dysglycemia versus controls). In adjusted analyses, PCOS with dysglycemia was associated with preeclampsia (odds ratio [OR] 2.9; 95% confidence interval [CI]: 1.4-6.1), whereas PCOS without dysglycemia was not (adjusted odds ratio [aOR] 0.53; 95% CI: 0.16-1.73). PCOS with dysglycemia was also associated with increased preterm birth (OR: 2.3; 95% CI: 1.04-5.14), abnormal neonatal weight (OR: 2.87; 95% CI: 1.36-6.10), neonatal hypoglycemia (OR: 2.8; 95% CI: 1.38-5.77), and any adverse pregnancy outcome (aOR: 4.49; 95% CI: 1.94-10.40). CONCLUSIONS:In this prospective cohort, dysglycemia was associated with higher rates of hypertensive and metabolic pregnancy complications among individuals with PCOS. These findings suggest that coexisting dysglycemia may contribute to heterogeneity in obstetric risk among individuals with PCOS and warrant confirmation in larger studies.
OBJECTIVE:To describe treatment patterns for perimenopause and menopause symptoms, including hormone therapy (HT), nonhormonal medications, and supplements and to examine peer, social, and structural correlates of HT use in a nationally representative sample of U.S. women. METHODS:In February 2025, a cross-sectional online survey was conducted through YouGov (n = 1,500 women). Eligible participants were women who reported being told by a healthcare professional (HCP) they were in perimenopause or menopause, or who were within the midlife age range associated with these stages (45-54 years). Participants reported symptom burden, treatment use, peer influences, and perceived barriers to care. Multivariable logistic regression was used to identify demographic and sociocultural predictors of HT use. RESULTS:Approximately half of the respondents reported vasomotor symptoms, yet only 7.2% reported current HT use. Marked disparities by education and income were observed: women with a 4-year college degree or higher had more than twofold higher odds of HT use, and those with household incomes >$100,000 had twice the odds compared with those earning <$20,000 (p < 0.001). Peer influence was independently associated with treatment choice: women whose peers used HT had 3.4-fold higher odds of HT use, whereas peer use of mind-body approaches was associated with 63% lower likelihood of HT use. CONCLUSIONS:In a nationally representative sample of U.S. women with substantial symptom burden, reported HT use was low. Treatment decisions were strongly shaped by sociodemographic disparities and peer influence, suggesting opportunities for targeted risk communication and equitable access to evidence-based menopause care.
BACKGROUND:Choosing antibiotics for prenatal urinary tract infections (UTIs) is challenging because fetal safety data are inconclusive and must be weighed against resistance. Recent information on prescribing patterns and antimicrobial susceptibility is sparse; we aimed to address this gap. STUDY DESIGN:We used electronic health record data from two US health systems (Kaiser Permanente Washington [KPWA] and Vanderbilt University Medical Center [VUMC]) to ascertain pregnancies from January 1, 2006, to August 31, 2023, to individuals aged 15-49. We included outpatient-treated prenatal UTIs with an oral UTI antibiotic plus a diagnosis or positive urine culture. We described patterns of antibiotic utilization and susceptibility overall (2006-2023) and by year (2010-2022). RESULTS:We identified 10,734 eligible UTIs. The most common antibiotics were nitrofurantoin (KPWA: 42%; VUMC: 65%) and first generation cephalosporins (KPWA: 23%; VUMC: 15%). Nitrofurantoin decreased substantially from 2010 to 2022 (KPWA: from 50% to 27%; VUMC: 65-49%), while first generation cephalosporins increased (KPWA: 12 to 45%; VUMC: 14 to 21%). Escherichia coli was susceptible to nitrofurantoin in 98-99% of UTIs. Susceptibility to other antibiotics was higher at KPWA than VUMC (first generation cephalosporins: KPWA: 97%, VUMC: 89%; amoxicillin-clavulanate: KPWA: 93%, VUMC: 85%). 93-95% were treated with an appropriate antibiotic based on susceptibility results. CONCLUSIONS:In two health systems in different regions, nitrofurantoin decreased substantially while first generation cephalosporins increased, despite better nitrofurantoin susceptibility. Other concerns, like malformation risk, may have influenced prescribing. Further research and guideline development are needed to weigh risks versus benefits of different antibiotics for prenatal UTIs.
INTRODUCTION:Disparities in women's health have been identified in clinical outcomes, research, and medical education. However, women's health education remains inconsistent in internal medicine training. Longitudinal women's health training tracks have proven positive impacts on trainees' confidence with women's health clinical practice, and graduates of these tracks go on to become leaders who further expand these efforts. Our objective was to update the 2023 Directory of Internal Medicine Residency and Fellowship Programs in Women's Health to provide trainees and clinician educators with a centralized list of U.S. internal medicine residency and fellowship women's health training programs. METHODS:We contacted women's health education program leaders from the 2023 directory to update their program information. We sent a recruitment email to the Sex-and Gender-Based Women's Health Education Interest Group listserv of the Society of General Internal Medicine and used snowball sampling to identify new programs. New program leaders were sent an electronic Qualtrics survey to confirm current program status, contact information, website, capacity, educational offerings, and program highlights. RESULTS:This directory describes 29 graduate medical education training programs in women's health for internists, with 12 residency programs and 17 fellowship programs identified. This is an overall increase from the 25 programs in the 2023 directory. DISCUSSION:This directory is a practical resource for trainees seeking educational experiences and for medical educators seeking opportunities for collaboration and leadership in women's health. The increase in training opportunities is a step toward comprehensive medical education and equitable, high-quality care and research in women's health.
