To define critical competencies in women's health for medical student education and to assess the degree to which they are taught. A set of competencies in women's health was developed. A multi-method needs assessment was implemented. Faculty and student evaluations revealed no major areas of disagreement but did identify major deficits in the basic sciences including the physiologic influence of estrogen on nongynecologic organ systems and of androgen on various organ systems, nutrition, and alternative medicine and the difference between the sexes in disease processes, presentation, and treatment. In the clinical years, there are important deficits in the teaching of diseases unique to women, limited attention to psychosocial aspects of women's health, and no cohesive teaching of a gender-specific approach to clinical evaluation. In the medical school curriculum, gender's effect on disease is inadequately addressed. An integrated longitudinal approach to gender-specific medicine is needed.