The Equal Curriculum: The Student and Educator Guide to LGBTQ Health by James R. Lehman, Kristine Diaz, Henry Ng, Elizabeth M. Petty, Meena Thatikunta, Kristen Eckstrandhis first-of-its-kind textbook marks a revolutionary effort to reform medical education nationally by providing a comprehensive, high-quality resource to serve as a foundation for lesbian, gay, bisexual, transgender, and queer (LGBTQ) health education across multiple disciplines.
Addressing the decades-long unequal weight of medical education generally offered about the care of LGBTQ people, The Equal Curriculum was created to advance clinicians' competencies in optimizing the health of LGBTQ people.
This textbook is designed to be integrated into health sciences curricula and offers pointed strategies to evaluate the integration of LGBTQ health topics.
Starting with a brief overview, chapters 1 through 4 cover general content that is highly relevant to all health professionals working with LGBTQ people.
In this paper, primary author Shane Snowdon, with assistance from advisory group members, has provided comprehensive recommendations to health professional schools on how to improve their climate for LGBT students, faculty and staff.
A Call for LGBTQ Content in Graduate Medical Education Program RequirementsA well-developed body of literature demonstrates that lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals experience poorer health outcomes and report worse health care experiences than straight/cisgender individuals. Many reforms since 2010 have addressed the LGBTQ-related education of future health care professionals at the undergraduate medical education (UME) level; however, reforms at the graduate medical education (GME) level are lagging, and new literature suggests that didactic education at the UME level is not enough to prepare future physicians to properly and compassionately care for LGBTQ patients. Recently, the Accreditation Council for Graduate Medical Education (ACGME) implemented a major revision of its Common Program Requirements that requires residents to demonstrate, as a competence, respect and responsiveness to diverse populations. Given these revisions and the ongoing failure of many GME training programs to adequately prepare future physicians to care for LGBTQ patients, the authors argue that now is the time for the ACGME to develop and implement LGBTQ health–related residency requirements. In addition, the authors outline a path by which the academic medical community may develop and implement these requirements.
Restructuring LGBTQ Curriculum in Medical SchoolsMedical schools in the USA and Canada report that a small amount of time is dedicated in undergraduate medical education to topics related to patients who are lesbian, gay, bisexual, transgender, or queer (LGBTQ), despite recent data that show medical students who have clinical encounters with LGBTQ patients not only had a more positive attitude toward this subset of the population but also were able to perform a more complete patient history [1, 2]. Medical students at a large west coast university were evaluated for preparedness and comfort when working with LGBTQ patients, and the study found that 67% of students ranked their LGBTQ medical curriculum as “fair or worse,” and most (70%+) did not feel comfortable discussing gender-affirming surgery and gender transitioning [3]. A study done at another university showed that medical students felt unprepared to attain a comprehensive sexual history that was inclusive of patients in the LGBTQ community and did not feel prepared to provide appropriate counseling [4]. This research reveals a need for medical students to gain readiness, knowledge, and greater experience in their medical training as it pertains to the LGBTQ community. In addition to the need, there is also a desire for advanced LGBTQ education found by medical students across the USA [5].
A Novel Curriculum for Medical Student Training in LGBTQ Healthcare: A Regional Pathway ExperienceLesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face considerable health disparities, often due to a lack of LGBTQ-competent care. Such disparities and lack of access to informed care are even more staggering in rural settings. As the state medical school for the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region, the University of Washington School of Medicine (UWSOM) is in a unique position to train future physicians to provide healthcare that meets the needs of LGBTQ patients both regionally and nationally.
A first step in addressing medical education Curriculum gaps in lesbian-, gay-, bisexual-, and transgender-related content: The University of Louisville Lesbian, Gay, Bisexual, and Transgender Health Certificate ProgramIndividuals who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming, and/or born with differences of sex development have specific health needs and significant health disparities exacerbated by a lack of training among health professionals. The University of Louisville LGBT Health Certificate Program used an interdisciplinary approach to increase training, potentially enabling future physicians to provide quality healthcare to LGBT patients. Methods: A pretest-post-test design was used to investigate medical students' (n = 39) attitude and knowledge outcomes after program participation. Attitudinal items with Likert-type responses were analyzed using the Wilcoxon signed-rank test. Baseline frequency and percentage of correct responses were tabulated for knowledge questions. At both pre- and post-test, the 11 knowledge items were summed to establish a total knowledge score, creating two total scores. The paired sample t-test was used to evaluate the pre- and post-change, and Cohen's D was used to assess effect size. All P values were two-tailed. Statistical significance was set by convention at P < 0.05. Results: Students correctly answered 69% or less of the knowledge questions at baseline. Total correct knowledge scores significantly increased post intervention with the effect size being large (Cohen's D = 0.90, P < 0.001). Attitudes significantly increased post intervention on two items (P = 0.019 and P = 0.037). Some attitude items decreased post intervention: students felt it is more challenging to conduct a patient history with a LGB patient (pre-mean agreement = 2.44; post-mean agreement = 2.97, P = 0.018). Conclusions: Medical educators can play a critical role in decreasing LGBT healthcare disparities. The University of Louisville LGBT Health Certificate Program played an important first step in increasing medical students' knowledge and improving certain attitudes about LGBT patients.
Incorporating LGBT Health in an Undergraduate Medical Education Curriculum Through the Construct of Social Determinants of HealthThe AAMC has provided a resource to medical schools for implementing curricular change in lesbian, gay, bisexual, and transgender (LGBT) health education. However, studies have identified that many health professionals who do not feel comfortable in their ability to provide quality care for LGBT patients do not perform complete sexual histories routinely and/or harbor bias towards these patients or their sexual practices. This situation underscores the continued need for further education on this topic.
The American Association of Medical Colleges provides a video series for educators looking to incorporate LGBTQ+ health into the curriculum. Includes topics such as "Teaching Gender Identity and Transgender Health" and "Teaching Differences of Sex Development."
From the American Medical Student Association (AMSA), these are "ready to go" projects that are packaged with instructions on how to run the event, powerpoints, handouts, video clips, and other supplemental materials.
This course has been designed with leaders in this rapidly expanding field and the World Professional Association for Transgender Health (WPATH), with the intention to improve how we as physicians can best support and maintain the health of our diverse patient populations.