Are medical students and residents receiving an appropriate education on LGBTQ+ health?

To the Editor

In 2016, about 10 million of US inhabitants identified themselves as part of the LGBT community. This represents a significant increase from 8.3 million in 2012 (Brown, 2017). With the growth in this population, it becomes important to minimize any inequalities; however, studies still show many health disparities (Bonvicini, 2017). The American Psychological Association (APA) commented that these disparities are from the lack of education in health care workers in LGBTQ+ health (American Psychological Association, 2013). Therefore, we conducted a survey to determine these gaps in education.

The survey was sent out to the University of Central Florida’s third- and fourth-year medical students, residents and fellows. The data consisted of 77 responses out of 584 (13%) with a good distribution in training level, specialties, sex, age, race, sexual orientation and religion. Of those medical students and residents who responded, approximately half (52%, n = 40) had a small amount or no interaction with LGBTQ+ patients during their training. Nonetheless, most (93%, n = 72) felt comfortable treating these patients. Those who had some level of discomfort (21%, n = 16) reported a crucial reason for this is due to the lack of education in their program. In fact, 39% (n = 30) did not feel that they received sufficient training. There were no differences in specialties; yet, when comparing between medical students and residents who responded, there were more residents that deemed their education in LGBTQ+ medicine to be inadequate. This may be partly due to increased awareness of education gaps with advanced clinical training. Unfortunately, the survey also suggests that most medical students and residents witnessed discrimination against this population through jokes, humor or bullying from other residents (99%, n = 76) or attendings (97%, n = 75).

We believe that medical schools and residency programs should modify curriculums for medical students and residents to include more LGBTQ+ education. Furthermore, there should be improved mechanisms for students and residents to report episodes of discrimination against LGBTQ+ patients with subsequent education for the offenders. The purpose of this paper is to advance further rigorous research to identify if educational gaps related to LGBTQ+ persisted in medical education. These gaps in education may lead to health care disparities; therefore, it is important to encourage more research on ways for improving medical students’ and residents’ education.