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LGBT topics get little time in med school
September 6th, 2011
04:51 PM ET

LGBT topics get little time in med school

Lesbian, gay, bisexual, and transgender patients present unique challenges to treating physicians, but their specific needs may not be getting enough attention in some medical schools.

44 medical schools reported dedicating no teaching time to LGBT-related content during clinical years, and in preclinical curricula, nine medical schools reported spending no time on LGBT issues, according to a study published Tuesday in the Journal of the American Medical Association.

Surveys used in the study were distributed to all 176 allopathic (conventional) and osteopathic medical schools in the U.S. and Canada, and 85% of schools responded.

Across all medical schools that participated, the median time spent on LGBT-related content was just five hours, though time spent varied widely by school.

Perhaps most surprising: 70% of responding schools evaluated their own LBGT curricula as ‘fair’, ‘poor’, or ‘very poor.’

"So that kind of said to us that there's some awareness that there could be better LGBT-related curriculum," says Dr. Leslie Stewart, one of the study authors.

Past studies have documented enormous health disparities between the LGBT community and non-transgendered, heterosexual peers.

Higher rates of anxiety, depression, suicidal thoughts, smoking, alcohol consumption, substance use, youth homelessness, harassment, sexually transmitted infections, and HIV/AIDS all affect the LGBT community, studies show.

In addition to persistent social stigma, there are structural barriers to health care access among the LGBT community, such as partners not qualifying for employer-sponsored health care coverage.

An Institute of Medicine report cites that 57% percent of Fortune 500 companies extend benefits to domestic partners of LGB employees, with far fewer smaller companies doing the same.

The study on LGBT medical curricula has its limitations.

Researchers assessed time spent explicitly on 16 different LGBT topics including sexual orientation, gender identity, mental health issues, LGBT adolescents, and coming out, but did not assess knowledge, attitudes, or skills directly.

It's difficult to determine how much of the relevant information on LGBT-issues is threaded into other lectures and discussions, says Dr. Raymond Curry, Vice Dean for Education at Northwestern University’s Feinberg School of Medicine.

“And even if you could more adequately assess what's going on in curriculum, even then, what's perhaps more important is the environment in which this education takes place” says Curry, who wrote an editorial about the study for JAMA.

“Is this an institution that is itself welcoming of a diverse group of students, patients, and staff? Because I think when you have that, if you're working in an environment that is itself a welcoming culture, the topics come up naturally.”


soundoff (105 Responses)
  1. WillH85

    I bet if it were up to the LGBT community 75% of the med student's training would be on their issues and not actual medicine. When did everyone in America become so overly sensitive?

    September 6, 2011 at 18:55 | Report abuse | Reply
    • Jennifer

      For much of the LBGT community effected(mostly transgendered) its about the doctoring knowing how to treat the patient properly. For instance the doctor may not know that the person has to be kept on certain meds, or else might go into a mad rage.

      September 6, 2011 at 23:42 | Report abuse |
    • Jenn

      For the same reason programs require classes and topics in multiculturalism–you're not just treating humans, you're treating people.

      September 7, 2011 at 02:22 | Report abuse |
    • everymom

      You'd lose that bet.

      September 7, 2011 at 17:29 | Report abuse |
    • Rose

      Are you aware that teens who are gay in the US have the highest suicide rate among adolescents? To be a good doctor you MUST be familiar with ALL types of people,behavior and illnesses. It is simply unacceptable that medical education excludes a certain population of people. I am appalled at the insensitivity of the comments above. Stereotypical prejudices have no place in good medical care. These comments reveal insensitivity and ignorance.

      September 8, 2011 at 08:42 | Report abuse |
  2. toddflanders

    I don't see this as being a problem. I'm sick of these special interest groups that want to have equal protection under the law, but also want to be treated specially by society.

    September 6, 2011 at 19:55 | Report abuse | Reply
    • Bacon

      Physicians have a responsibility to save lives, not live in your fantasy world of political opposition. It's not my job as a future physician to judge people based on their lifestyle. It's my job to make sure they become and stay healthy. So, yes, I do need to know common illnesses amongst LGBT communities as well as how to treat them.

      September 7, 2011 at 10:32 | Report abuse |
    • Steven

      Fine, give us equal protection. Hasn't happened (yet). So get over it, we won't stop fighting.

      September 7, 2011 at 11:28 | Report abuse |
    • equality

      For a long time, male doctors didn't study or learn about female anatomy or female-related biology, including birthing babies. Thankfully, that non-equal "special interest group" is now approaching equality as far as parity of care with males. Women exist and so do LGBT people so physicians should know about their physiology, biochemistry and mental health issues so they can be treated like every other human being (who has insurance).

      September 7, 2011 at 17:36 | Report abuse |
    • platon

      Thats a ridiculous comment. Lesbians and gays have the same internal organs taht everybody else does. I challenge the LGBT gurus out there to do random autopsies on dead people and say "HEY LOOK THIS GUY IS GAY, HE'S GOT THE GAY ORGAN!"

      LMAO

      September 8, 2011 at 21:28 | Report abuse |
  3. plbt

    I'm fully supportive of the lgbt community, but I don't see how most of these topics are relevant to medical science studies. The mental health issues could be covered during a psych residency and to be blunt seem like commonsense. I think a much bigger concern is how little pharmacology education doctors receive in medical school. Time is limited, obviously all topics can't be covered in depth.

    September 6, 2011 at 20:07 | Report abuse | Reply
  4. KK

    Wow, you commenters see doctors being educated about the health concerns of a minority community so that they are able to have access to appropriate health care a "special right" which is not "relevent" to medical science? I hope none of you end up ever being my doctor!

    September 6, 2011 at 21:58 | Report abuse | Reply
    • plbt

      My point is that most of the issues are not directly related to health from a medical standpoint. "youth homelessness and harassment" are better dealt with by a social worker, not a medical doctor. Those are the people who should be receiving the education. I'd rather my doctor understand the biology and science behind the diseases, not how to help me out of the homeless shelter.

      September 6, 2011 at 22:26 | Report abuse |
    • Jennifer

      A doctor knowing all about GLBT issues won't do his GLBT patients much good if they come to him for cancer or pneumonia or some unrelated heath condition, and he has no idea how to treat it because he wasted half his time in med school learning about the root causes of homelessness and unequal access to medical care... neither of which is an exclusively GLBT issue anyway.

      September 8, 2011 at 05:09 | Report abuse |
    • platon

      Jennifer is exactly right. Med school has limited time. So if you want to cram all this liberal feelgood social BS down our throats then we arent going to learn as much pharmacology, pathophysiology, anatomy, etc.

      I want a doctor who knows the correct medications and doses for HIV; not some fool who will hold my hand and explain to me the social dynamics of gay partnership but who cant tell me what the major side effects of the reverse transcriptase inhibitors.

      September 8, 2011 at 21:33 | Report abuse |
  5. Kris

    Where, exactly, does the article say that the "glbt lifestyle" (your words) is not healthy? Pretty pompous comment, in general... When I grow up, I'd like to live the same perfect "lifestyle" that you do! (NOT!)

    September 6, 2011 at 22:47 | Report abuse | Reply
  6. DavidGram

    These folks never miss a chance to play the victim. I understand what they're doing - this kind of thing has a political payoff, and for some, it's become a kind of religion. I'm just wondering how long it will be before a real backlash develops. The drum beat never stops. Every day in the news, it's gay this, gay that. People are getting fed up.

    September 7, 2011 at 01:15 | Report abuse | Reply
    • IB

      You're really looking forward to that "backlash" aren't you?

      September 7, 2011 at 04:01 | Report abuse |
    • Johnny

      Hopefully there'll be a backlash against idiots one day. I hope you're a fast runner.

      September 7, 2011 at 10:12 | Report abuse |
    • Rose

      In the 60's we read and heard a LOT about Civil Rights. We are hearing a lot about gays because they too, like Blacks , are subject to predjudice like that the above writer exemplifies.Compassion is the prerequisite for excellence in medical care. It should also be considered a prerequisite for being a decent human being. The lack of compassion in some of these comments scares me. Physicians treat ALL people and need therefore to know about ALL people.

      September 8, 2011 at 08:51 | Report abuse |
    • platon

      I suppose the next thing you are going to tell me is that in order to be a good doctor I have to take a civil rights course so I'll "understand" how older african americans dealt with racism. And after that you'll tell me that I'll have to take a course in asian history so I'll know how to treat the local Vietnamese patient population.

      Give me a break.

      September 8, 2011 at 21:36 | Report abuse |
  7. Jenn

    You're comment might hold water if being LGBT were a choice. (It isn't.)

    September 7, 2011 at 02:28 | Report abuse | Reply
  8. doc

    You want to hear a real injustice; my medical school spent virtually no time discussing creationlism, canibalism or modern literature!

    September 7, 2011 at 08:17 | Report abuse | Reply
    • Rose

      Doc-your lack of compassion and insensitivity is appalling! If this is what med schools are turning out, it points to not only a need to educate med students about all people, but a crash course in simple human kindness.

      September 8, 2011 at 08:54 | Report abuse |
  9. txwtch67

    And for the record, I'm straight. I just happen to live by morals others just tend to give lip service to.

    September 7, 2011 at 09:25 | Report abuse | Reply
  10. WWRRD

    More time spent understanding the specific medical needs of Women, and children would be a better use of time than LGBT interests.

    September 7, 2011 at 09:26 | Report abuse | Reply
    • DrMatrix

      They are not mutually exclusive. Addressing LGBT issues does not mean they cannot also address women's and children's issues.

      September 7, 2011 at 16:51 | Report abuse |
    • Jennifer

      There are several specialties devoted to the unique needs of women and children. Just saying.

      September 8, 2011 at 05:11 | Report abuse |
  11. posterwolf

    Yikes, the hostility displayed in these comments shows exactly why LGBT topics are important. And the information is very relevant. If a doctor has an African American patient, I hope he is educated about the higher incidence of type 2 diabetes among that group so he can monitor the patient appropriately. Likewise, if the doctor is educated about HIV prevention, co-factors and rates with the gay community, he can better help his gay patient stay healthy. This isn't rocket science, folks.

    It's not some caving to political correctness to address the health needs of minority groups.

    September 7, 2011 at 09:58 | Report abuse | Reply
  12. Johnny

    Too bad your doctor hasn't informed you that you're a mental midget.

    September 7, 2011 at 10:11 | Report abuse | Reply
  13. Michelle

    I'm gay. I have an extremely low-risk "lifestyle." I'm drug-free and disease-free. I'm married and monogamous with a person who has NO STD's and doesn't use drugs. I drink only in moderation, don't use tobacco, exercise 5 time per week, and engage in outdoor activities.

    So, why does a doctor need to know about my different health needs? Because:

    1) I'm not having kids, and it was insulting and offensive to go to a doctor (someone in whom I'm supposed to place my trust for my health) who wanted to treat me like I was nothing but a breeding machine that hadn't found its purpose. He had his own ideas about what my so-called lifestyle was because I'm gay, and imposed those prejudices on me as he spoke to me, ignoring the problem I'd gone there to address.

    2) I'm also gender-variant. They wanted to treat a hormonal imbalance and ovarian cyst problem I have by dosing me with estrogen, which would have made my breasts enlarge and would have ruined the quasi-masculine physique I have, which is one of the things I love most about myself. The doctor refused to understand that I don't want to be more feminine. NOT even in the slightest. He refused to see that his "treatment" would ruin part of my quality of life, but because his approach was the "most common" treatment for polycystic ovaries that he used, he didn't want to consider other options.

    3) When I saw one doctor to address problems that seemed to be related to inflammation from a rheumatoid arthritis-like condition that I have, the guy was more concerned with imposing his misinformed GLBT prejudices on me.

    So, if you think that the lack of education for GLBT issues doesn't impact real human beings in their health care, think again.

    And on top of that, don't even get me started on the transgendered friend of mine (female to male), who hadn't had "lower" surgery yet, who couldn't even get a doctor to give him a basic gynecological exam to screen for the usual problems like cervical cancer.

    This has nothing to do with political correctness, and everything to do with REAL PEOPLE simply needing access to health care services from doctors who aren't clueless.

    September 7, 2011 at 10:23 | Report abuse | Reply
    • Bacon

      As a medical student, I agree with what you're saying. I also implore you not to assume doctors learn "everything" in medical school. We can barely cram in all of the hard sciences in two years and clinical skills in the next two. The entire point of residency is to get you "up to date" with real-world health issues. If I entered primary care with a large LGBT population, you can rest assured that I would be expected to learn as much about their unique health risks as possible. The problem is that medical school itself is not where you learn how to practice medicine – it's where you learn basic sciences and clinical skills. I could no more tell you about the unique health risks associated with native americans than you could tell me. This is something I'd learn in residency as a primary care physician.

      Do you honestly think all physicians coming out of medical school are skilled in brain surgery? Of course not. We know brain anatomy and that's it.

      We graduate with the tools and thinking skills necessary to LEARN about specific community health issues, but it's up to post-medical school education to complete us.

      September 7, 2011 at 10:44 | Report abuse |
    • DKB

      I want to thank both Michelle and Bacon for their thoughtful and informative responses. I think you both highlight the problems in a very real way from both sides of the isle. I hope more people read your perspectives.

      September 7, 2011 at 13:16 | Report abuse |
    • Jen

      Hate to tell ya, but I've had PCOS symptoms and cysts, and all my ob/gyn ever wanted to do was give me the pill to up my estrogen, too. It's a band- aid they like to use. Don't think you're the only one getting bad treatment. 😉

      September 7, 2011 at 23:37 | Report abuse |
    • Jennifer

      1) I don't want kids either. I'm straight. I got my tubes tied, and that was the end of it. I had to go through several paternalistic idiots before I found a doctor who would do it, but it's not a GLBT issue. In fact, I know many gay or bi women who want and intend to bear children – a doctor who assumed otherwise would be accused of being a bigot.

      2) GLBTs are not the only people who would object to unnecessary massive hormone treatments. Whether the doctor understands or agrees with your reasons for refusal is irrelevant – tell him 'no', and move on. Doctors disagreeing with patients' life choices isn't a GLBT issue, either.

      3) Sounds like the guy was a jerk – however, if you're seeing him for rheumatoid arthritis, why does he even KNOW you're GLBT? Seriously, how did that even come up? Your hormone imbalance may be diagnostically relevant, but the fact that you prefer women isn't, and I can't imagine he would have asked about it.

      Doctors are human beings, and just like everyone else, many of them are jerks. If you grow up and stop relying on them (or anyone else) for validation of your life choices, you'll be a much happier person.

      September 8, 2011 at 04:58 | Report abuse |
  14. Bacon

    Let me start by saying i am a medical student. This issue is not a failure of medical schools addressing LGBT community issues, it's a failure of medical schools in addressing public health in general. I can also say, with very little regret, that we already have such an incredibly vast amount of material to cover as it is that we honestly don't have the time to "get specific". Specificity in medicine begins in residency, not medical school. Years 1 and 2 consist entirely of hard sciences that underly the human body. Years 3 and 4 help build clinical skills and help you find out what your interest is. LGBT (and, by proxy, public health issues in general) problems would likely be addressed either at this time or during residency in sectors where these issues are prevalent.

    Medical school is commonly considered to be "like drinking from a fire hose". We just don't have the time or memory capacity to go into very specific public health issues. It's regrettable, but it's also reality.

    September 7, 2011 at 10:30 | Report abuse | Reply
  15. Josh

    Are we talking about LGBT med students, or LGBT future patients of these med students?

    If, for say, that 10% of the population is LGBT, then I would assume that 10% of med students are themselves LGBT, and if you are LGBT you should seek out of those to be your sympathetic doctor.

    September 7, 2011 at 12:45 | Report abuse | Reply
    • mikel

      It's only 1%

      September 7, 2011 at 13:01 | Report abuse |
  16. ProgressiveMike

    Med students and residents are severely pressed just to master the basics of medicine and develop the right instincts for diagnosis and treatment. LGBT issues are a specialty, and the education for that ought to be acquired at the same time of training for any other specialty.

    September 7, 2011 at 12:52 | Report abuse | Reply
  17. mikel

    That's because whining is not a medical condition.......

    September 7, 2011 at 13:01 | Report abuse | Reply
    • IB

      Neither is your stupidity........

      September 7, 2011 at 15:42 | Report abuse |
  18. Ed

    I think the amount of training is appropriate. The concerns regarding these freaks of nature should be directed to Barnum and Bailey where the rest of the sideshow acts perform.

    September 7, 2011 at 16:07 | Report abuse | Reply
  19. Medstudent

    I am a medical student. I believe some of you have been misled by what CNN is reporting (probably because CNN meant to report it as such). If only 9 schools are NOT teaching about LGBT that means that over 93% of schools in this country ARE teaching LGBT issues and treatment during the first 2 years of learning. I know that at my medical school we spent about an hour or two dedicated solely to the topic. All of the pertinent illnesses that come with an LGBT lifestyle are also taught; not in a dedicated "LGBT hour" but intermixed in the curriculum. So my question to the commenters who say that medical schools are not doing their job by ignoring LGBT, how many hours should I spend on LGBT? Just to give you some perspective for your answer, in four hours today I learned about every single STD and UTI known to man.

    Please understand that the generation of doctor that you have grown up with was NOT taught about LGBT, we are. It is also a much more accepting time than when they grew up in, so in 10 years when I am your doctor it will be much different.

    September 7, 2011 at 21:57 | Report abuse | Reply
  20. CINTIJACK

    Thanks for letting us all know why you aren't a doctor.

    September 7, 2011 at 22:15 | Report abuse | Reply
  21. Beefburger

    If transgenders can afford the "change" then they can afford a doctor that at least acts like they care. Unless they are on the public dole, in which case there is very little pity for issues with such an ELECTIVE proceedure.

    September 8, 2011 at 04:34 | Report abuse | Reply
  22. Beefburger

    @Josh, Woah there son! Where do you get 10% from, the highest I've ever seen in a survey was 3.2% self-identifying as LGBT and that was a UC Berkly poll so I highly doubt that people were "staying in the closet".

    September 8, 2011 at 04:37 | Report abuse | Reply
  23. Beefburger

    @Michelle, have you stopped to think that the hormone imbalance that "makes you you" is also what is making you sick? Also, it is so sad to think that you define yourself by this hormone imbalance.

    September 8, 2011 at 04:40 | Report abuse | Reply
  24. Jennifer

    LGBT isn't the only group to have a higher incidence of depression and substance abuse or reduced access to medical care – med students already learn about those things, and adding LGBT to the list doesn't require extra teaching time... so why are they asking for it?

    September 8, 2011 at 04:42 | Report abuse | Reply
  25. Beefburger

    @Medstudent, THEY think you should be learning LBGT issues 24/7. It isn't so much the gay women as it is gay men that seem to have these HUGE ego issues. I have met very few gay men that didn't have the "universe revolves around me" complex. They are so in love with their own pen1s that they think you should worship it too.

    September 8, 2011 at 04:45 | Report abuse | Reply
    • Bacon

      "They are different than ME" is known as Xenophobia, which is a real psychiatric phenomenon that you are exhibiting. It's a logical fallacy to assume that "this person lives a certain way" equals "this person is fundamentally motivated by different things than me". Anyone who's traveled the world and actually experienced/talked to other people than "good old down home americans" will tell you how quickly it changed their perception of "others". Humanity operates under very similar principles, desires, disdains, etc. A playboy is no less of an egotist than someone who is overly flamboyant. You simply choose to acknowledge only one of the two.

      Of course, what do I know, I'm only a medical student with a master's degree in health administration. I'm sure you could "lecture" me on why the health care system is broken, couldn't you?

      September 8, 2011 at 11:21 | Report abuse |
  26. Man-animal

    Doctors have a responsibility to treat patients. No where in their training should there be special exceptions for any minority group.

    September 8, 2011 at 05:37 | Report abuse | Reply
    • Bacon

      "Special exemptions"? Excuse me? We have to learn about sickle cell incidence amongst african-americans (much higher than amongst caucasians). Why should we not also know about the unique risk factors associated with the LGBT community? Don't assume that every single person/lifestyle has similar risk factors and illnesses.

      September 8, 2011 at 11:23 | Report abuse |
  27. larry

    They could just create a specialty classification for a Doctor that threats only these issues and leave med school alone. There is enough to do in med school without pressure from some noisy splinter group. Other than that it's a waste of time.

    September 8, 2011 at 08:54 | Report abuse | Reply
  28. Sultan

    Medical school is for learning basic science and developing a foundation of knowledge and interview skills. It is not meant to learn how to treat people, deal with specific groups, or even practice medicine. The article is misleading and uninformed, created only to spark anger and promote further misunderstanding. Residency is where people are to learn how to actually practice medicine and deal with the issues highlighted in the article, particularly with regards to primary care residencies.

    Medical school ideally puts students on a level where they can begin to learn how to apply what they know, including towards "special interest" groups, minorities, cultural differences and backgrounds. That application is taught later though. You have to crawl before you can walk.

    September 8, 2011 at 11:15 | Report abuse | Reply
    • Bacon

      Bingo. Medical students only learn the most basic level of medical practice in med school. Biochemistry, Cell Biology, Interview skills, gross anatomy, histology, drug and disease treatment, etc.

      If I were to enter primary care I would expect to learn about these issues during residency.

      September 8, 2011 at 11:25 | Report abuse |
  29. platon

    Here's a list of all the special interest topics that all these fools want doctors to learn:

    1. Gay patients
    2. Lesbian patients (its an insult to assume you can combine 1 and 2 into the same curriculum)
    3. African american culture
    4. Latino culture
    5. Asian american culture
    6. Rural redneck culture (god forbid the appalachian folk get abandoned)
    7. Women reproductive issues
    8. Domestic violence
    9. Child abuse
    10. Poverty
    11. Homelessness

    Now if you saw this list, would you think the person who trains in this is a doctor or a social worker?

    DOCTORS SHOULD FOCUS ON MEDICINE; IF YOU WANT A SOCIAL WORKER THEN GO FREAKIN HIRE A SOCIAL WORKER!

    September 8, 2011 at 21:45 | Report abuse | Reply
  30. Kim

    Good article, but poorly proofread. LGBT or LBGT?

    September 11, 2011 at 02:16 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.