Medical students spend hours learning about human health, behavior and how to provide good patient care. But when it comes to caring for lesbian, gay, bisexual and transgender individuals, their training may fall short.
According to a new survey of medical school deans in the U.S. and Canada, schools spent a median of just five hours teaching LGBT-related health content. Some 33 percent provided no LGBT-related instruction during students' clinical years, which is when students receive the most hands-on training, and nearly 4 percent of schools reported not covering LGBT health at all.
"This survey confirms what we have said all along: Health professional training schools in general do not adequately address LGBT health needs," said Hector Vargas, executive director of the Gay and Lesbian Medical Association, a nonprofit which aims to combat homophobia in the medical profession.
According to the U.S. government's Healthy People program, such needs can include specific adolescent and adult mental health issues, drug and alcohol use, obesity and risk of sexually transmitted infections.
The authors of the new study -- which was conducted by Stanford University's LGBT Medical Education Research Group and published in the Journal of the American Medical Association -- did find that 97 percent of the schools surveyed taught students to ask patients if they have sex with men, women or both when asking about sexual history.
But fewer schools emphasized the difference between sexual behavior and identity -- just 72 percent indicated they teach students, for example, that some men may have sex with other men but still identify as straight.
"There's a bit of a disconnect there," said William White, a medical student at Stanford University and one of the study's authors. "That's a more nuanced and complicated question. It gets down to the idea of, 'Do students understand what it means to identify as [an LGBT individual] and do they understand that some people don't identify with a population, but can still have its risks.'"
Vargas added that the new study highlights the pressing need to improve "cultural competency" among medical professionals. Such competency encompasses a broad set of skills health care professionals need in order to provide high-quality care to patients, including being "welcoming" and "nonjudgmental" so that patients feel comfortable opening up.Some estimates suggest that LGBT patients are almost twice as likely as heterosexual adults to delay seeking health care or avoid it altogether.
The new study does indicate a slight increase in the amount of time spent teaching LGBT-related health care issues.
A 1992 survey sent to medical schools' psychiatry departments found that on average, 3.43 hours were spent on what the survey called "the topic of homosexuality" -- primarily in human sexuality lectures. Though the authors of the new Stanford study write that direct comparison between the two surveys is difficult given differences in methods and sampling, White said it is safe to say that there has been a slight increase in the amount of time spent on teaching LGBT-related health issues over the past two decades.
But there is still a long way to go. White pointed out that 44 percent of the deans surveyed said their coverage of LGBT content was "fair" overall, while 26 percent said it was "very poor."
"That's a shocking finding," he said. "Because in medical education, we strive for excellence."
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