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.”