SCIENTIFIC
LGBT Medical Education Assessment in West Virginia
AUTHORS : Elizabeth Duarte , MD
Mahreen Hashmi , MD West Virginia University School of Medicine Department of Obstetrics and Gynecology Medical Center Dr , Morgantown , WV 26506 Telephone : ( 304 ) 598-4880
Kylie Fuller , MD
CONFLICTS OF INTEREST : None
INTRODUCTION
It has been well-documented that lesbian , gay , bisexual and transgender ( LGBT ) individuals face unique healthcare concerns with regards to their physical , mental , behavioral , and sexual health . 1 – 4 Furthermore , inadequate legal protections from discrimination and a shortage of healthcare providers with the training to provide culturally competent care create barriers that likely contribute to increased rates of obesity and certain cancers , infections , and chronic diseases in this population , 5 LGBT individuals may also have inadequate insurance coverage , and face discrimination and negative encounters with healthcare providers . 6
In 2007 , the Association of American Medical Colleges ( AAMC ) made their first recommendations about including educational efforts regarding LGBT patient care . 7 The memorandum recognized the professional obligation for future physicians to respectfully care for all patients , including those who identify as belonging to a sexual and / or gender minority group . The memo also recommended that medical school curricula include specific training to ensure students are able to provide comprehensive care for LGBT patients . 7 In 2014 , the AAMC published a report identifying 30 competencies recommended for training physicians to assess and interact more effectively with patients . 8 Despite the
ABSTRACT
BACKGROUND Lesbian , gay , bisexual and transgender ( LGBT ) individuals experience healthcare disparities related to their physical , mental , behavioral , and sexual health . Educating medical students about how to address this public health issue is a priority of the Association of American Medical Colleges and all medical schools across the country . Yet , the training to care for LGBT patients has been inconsistent , and it is unknown how comprehensively these competencies are being addressed at the two allopathic medical schools in West Virginia ( WV ).
METHODS An online questionnaire was distributed to medical students at the two allopathic medical schools in WV to evaluate perceptions of the curricula with respect to care for LGBT patients .
AAMC recommendations , the training to care for patients who identify as sexual and gender minorities has been inconsistent . 9 Recent questionnaires of medical students and deans across the United States ( US ) have shown that there are still significant gaps in curricula , with two-thirds of students surveyed at 170 allopathic and osteopathic medical schools in the US and Canada rating their LGBT-related curriculum as “ fair ” or “ worse than fair .” 1 , 2 The authors set out to determine how comprehensively West Virginia ( WV ) allopathic medical schools addressed LGBT competencies .
Given previous studies , we hypothesized that allopathic medical students in WV did not feel adequately prepared to care for LGBT patients . Therefore , we examined students ’ evaluations of their schools ’ curricular content , specifically to assess students ’ level of comfort and level of preparedness in treating LGBT patients and how those levels changed as a result
RESULTS Medical students ( N = 91 ) felt prepared to address 9 of 16 LGBT-specific subject areas . The majority of students felt prepared to discuss sexual orientation ( 64 / 91 ; 70.3 %) and human immunodeficiency virus ( 60 / 91 ; 65.9 %). Fewer students felt prepared to discuss sex-reassignment surgery ( 17 / 91 ; 18.7 %) and transitioning ( 21 / 91 ; 23.1 %). Overall , 82.4 % of respondents reported feeling “ comfortable ” or “ somewhat comfortable ” with LGBT health issues . Medical school education helped 59.3 % of respondents feel “ more comfortable ” and 65.9 % of respondents feel “ more prepared ” to provide medical care to LGBT patients .
CONCLUSION Our data suggests that medical school curricula in WV has increased student-rated comfort and preparedness in providing medical care to LGBT patients , but should be further developed and standardized to reduce the perceived knowledge gaps .
of their specific LGBT curriculum at their medical school .
METHODS Study Design A voluntary , anonymous , online questionnaire was emailed to medical students at West Virginia University School of Medicine ( WVU SoM ) and Marshall University Joan C . Edwards School of Medicine ( Marshall ). The study was approved by the WVU SoM Institutional Review Board with the required informed consent . The questionnaire instrument was created by researchers at Stanford University and permission to use the instrument was obtained prior to initiation of the study ( see Acknowledgements ). The questionnaire was distributed via email and administered using Survey Monkey . It was open to all medical students enrolled at WVU SoM and Marshall .
Outcomes The topics in the questionnaire focused on
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