Lesbian, Gay, Bisexual, and Transgender–Related Content in Undergraduate Medical Education
- Juno Obedin-Maliver, MD, MPH;
- Elizabeth S. Goldsmith, BA;
- Leslie Stewart, MD;
- William White, MA;
- Eric Tran, BA;
- Stephanie Brenman, BS;
- Maggie Wells, BS, BA;
- David M. Fetterman, PhD;
- Gabriel Garcia, MD;
- Mitchell R. Lunn, MD
- Author Affiliations: Lesbian, Gay, Bisexual, and Transgender Medical Education Research Group (Drs Obedin-Maliver, Stewart, Fetterman, Garcia, and Lunn, Mss Goldsmith, Brenman, and Wells, and Messrs White and Tran), and Office of MD Admissions, Division of Gastroenterology and Hepatology, Department of Medicine (Dr Garcia), Office of Medical Education (Dr Fetterman), Stanford University School of Medicine, Stanford, California; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco Medical Center and University of California San Francisco School of Medicine (Dr Obedin-Maliver); University of Arkansas at Pine Bluff and Fetterman and Associates, San Jose, California (Dr Fetterman); and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Lunn).
Abstract
Context Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health and health care disparities and have specific health care needs. Medical education organizations have called for LGBT-sensitive training, but how and to what extent schools educate students to deliver comprehensive LGBT patient care is unknown.
Objectives To characterize LGBT-related medical curricula and associated curricular development practices and to determine deans' assessments of their institutions' LGBT-related curricular content.
Design, Setting, and Participants Deans of medical education (or equivalent) at 176 allopathic or osteopathic medical schools in Canada and the United States were surveyed to complete a 13-question, Web-based questionnaire between May 2009 and March 2010.
Main Outcome Measure Reported hours of LGBT-related curricular content.
Results Of 176 schools, 150 (85.2%) responded, and 132 (75.0%) fully completed the questionnaire. The median reported time dedicated to teaching LGBT-related content in the entire curriculum was 5 hours (interquartile range [IQR], 3-8 hours). Of the 132 respondents, 9 (6.8%; 95% CI, 2.5%-11.1%) reported 0 hours taught during preclinical years and 44 (33.3%; 95% CI, 25.3%-41.4%) reported 0 hours during clinical years. Median US allopathic clinical hours were significantly different from US osteopathic clinical hours (2 hours [IQR, 0-4 hours] vs 0 hours [IQR, 0-2 hours]; P = .008). Although 128 of the schools (97.0%; 95% CI, 94.0%-99.9%) taught students to ask patients if they “have sex with men, women, or both” when obtaining a sexual history, the reported teaching frequency of 16 LGBT-specific topic areas in the required curriculum was lower: at least 8 topics at 83 schools (62.9%; 95% CI, 54.6%-71.1%) and all topics at 11 schools (8.3%; 95% CI, 3.6%-13.0%). The institutions' LGBT content was rated as “fair” at 58 schools (43.9%; 95% CI, 35.5%-52.4%). Suggested successful strategies to increase content included curricular material focusing on LGBT-related health and health disparities at 77 schools (58.3%, 95% CI, 49.9%-66.7%) and faculty willing and able to teach LGBT-related curricular content at 67 schools (50.8%, 95% CI, 42.2%-59.3%).
Conclusion The median reported time dedicated to LGBT-related topics in 2009-2010 was small across US and Canadian medical schools, but the quantity, content covered, and perceived quality of instruction varied substantially.
