September 9, 2011
U.S. and Canadian medical schools devoted, on average, just five hours in their entire curriculum to teaching content related to lesbian, gay, bisexual, and transgender patients, according to a survey of the schools' deans.
Nine percent of the 132 deans who fully completed the web-based survey said their school devoted zero hours to LGBT topics during students' preclinical years, while one-third reported spending zero hours on these issues during the years students work with patients. More than one-quarter of the deans said their school's coverage of 16 related topics -- including sex-change surgery, mental health issues, and HIV/AIDS -- was "poor" or "very poor."
In 97 percent of the schools, future physicians are taught to ask patients whether they "have sex with men, women or both." The overall curriculum, however, lacked the depth of instruction needed to help "students carry that conversation as far as it needs to go," said lead author Dr. Juno Obedin-Maliver of the University of California-San Francisco.
"I'm an ob-gyn, and I have had lesbian patients come to me and say 'I haven't had a Pap test in 20 years because my doctors said I didn't need one,'" Obedin-Maliver said, adding that in fact, lesbians needs to undergo this screening as often as heterosexual women do.
A recent Institute of Medicine report noted there is little research to guide doctors in treating their gay and lesbian patients. It is known, however, that these patients are at increased risk of depression, suicide attempts, homelessness, and violence. Lesbians and bisexual women have higher rates of obesity and breast cancer, and they may receive less preventive care.
The study, "Lesbian, Gay, Bisexual and Transgender-Related Content in Undergraduate Medical Education," and an accompanying editorial, "Capturing Curricula," were published in the Journal of the American Medical Association (2011;306(9):971-977, and 997-998).