08:55am Saturday 28 March 2020

Medical Schools Spend Small Amount of Time Teaching Content Related to Health of Gay, Lesbian, Bisexual and Transgender Patients

This research is published in the September 7 issue of the Journal of the American Medical Association.

“A 2011 Institute of Medicine (IOM) report on the health of LGBT individuals states that ‘Although LGBT people share with the rest of society the full range of health risks, they also face a profound and poorly understood set of additional health risks due largely to social stigma,’ said Mitchell R. Lunn, MD, senior author, resident physician in internal medicine at Brigham and Women’s Hospital, and a co-founder of the Stanford LGBT Medical Education Research Group.  “Compared with heterosexual and nontransgender socioeconomically matched peers, LGBT individuals are more likely to face barriers accessing appropriate medical care, which may create or increase existing disparities.  Medical education organizations, such as the Association of American Medical Colleges (AAMC), have called for LGBT-sensitive training, but our research shows that not only are there very few hours spent educating our future physicians about LGBT health.  Additionally, 70 percent of the deans rated the overall LGBT-related content in their schools as fair, poor or very poor.”

Researchers from the Stanford LGBT Medical Education Research Group surveyed deans of medical schools in the U.S. and Canada to complete a 13-question web-based questionnaire between May 2009 and March 2010 to evaluate the presence and coverage of LGBT-related content.  Of the 176 schools, 150 (85 percent) responded, and 132 (75 percent) fully completed the questionnaire.  Based on the responses, researchers determined that the median reported combined hours dedicated to LGBT content was five hours.  Additionally, 44 medical schools reported zero hours of LGBT content during clinical years, nine schools reported zero hours during preclinical years and 5 schools reported zero combined hours.

They also report wide variation among the schools in quantity, content and perceived quality of instruction.  Regarding the presence or absence of 16 LGBT-related topics in their required curricula, 62.9 percent of the schools reported teaching at least half of the 16 topics and 8.3 percent reported teaching all 16 topics.

“Our findings indicate that there is a dissatisfaction with medical school coverage of LGBT content at a number of schools and suggest room for improvement in LGBT-related curricula. The deans we surveyed suggested several strategies to improve education related to the health of LGBT patients, which included curricular material focusing on LGBT-related health and health disparities’ and having faculty willing and able to teach LGBT-related curricular content,” said Lunn.  “We propose several specific recommendations to improve LGBT-related curricular content that include developing a standardized list of required LGBT topics at all medical schools, testing student’s LGBT health knowledge on a national board examinations, and developing up-to-date LGBT-related curricular materials.”

Other co-authors include current Stanford medical students Elizabeth Goldsmith, William White, Stephanie Brenman and Maggie Wells; Juno Obedin-Maliver, MD, MPH, an obstetrics and gynecology resident at the University of California – San Francisco and Leslie Stewart, MD, an internal medicine resident at the University of Pennsylvania; Eric Tran, an MFA student at the University of North Carolina-Wilmington; David Fetterman, PhD, former director of evaluation at Stanford School of Medicine, currently president and CEO of Fetterman & Associates; and Gabriel Garcia, MD, associate dean of medical school admissions and professor of medicine at Stanford.

This research was funded by Stanford University School of Medicine Office of the Dean and the Office for Diversity and Leadership, the Haas Center for Public Service at Stanford University, the Stanford University LGBT Community Resources Center, and the Stanford Medical Scholars Fellowship Program.

More information about the research group, its members, and its research projects is available at http://med.stanford.edu/lgbt/.

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