Monitoring student education and confidence in LGBTQ+ health in UK medical schools

Abstract

Objectives:

We sought to evaluate and describe UK medical students’ experiences of education in LGBTQ+ (lesbian, gay, bisexual, transgender and queer) health and their confidence in approaching these consultations and identify any perceived gaps in medical school curricula. We also sought to examine whether individual identity affected medical students’ clinical practice.

Method:

A 19-question questionnaire collecting quantitative and qualitative responses was sent to all medical students in the UK.

Results:

A total of 307 students completed the questionnaire; 36% (n = 184) reported no dedicated teaching on LGBTQ+ health issues/inequalities and 88% (n = 267) reported no LGBTQ+-specific communication skills training. Respondents found it more challenging to discuss LGBTQ+ health issues with patients compared to performing clinical examinations on LGBTQ+ patients. In the clinical environment, students were more likely to ask about sexual orientation, gender identity and pronouns within the context of sexual health over psychiatric, surgical and medical consultations. Measured via a Likert-type scale from 0 to 100, students felt LGBTQ+ health teaching should be given higher importance within the curriculum (74/100) than their medical school currently placed on it (13/100). Ninety-five percent of students stated that they needed further education on LGBTQ+ health.

Conclusion:

Findings suggest that at a national level, UK medical students do not feel well equipped to deal with LGBTQ+ health issues, and despite students’ recognition of the importance of this topic, this is not matched by curricular provision. Students report having difficulty discussing LGBTQ+ health issues and performing examinations on LGBTQ+ patients. Further training on LGBTQ+ health and actions to increase student confidence could help improve LGBTQ+ patient outcomes and improve the relationship between patients and clinicians. Students should be consulted in the re-development of relevant curricula.

Keywords

Education inequalities LGBT LGBTQ+medical education queer health

Get full access to this article

View all access options for this article.

References

Arthur

Jamieson

Cross

, et al. (2021) Medical students’ awareness of health issues, attitudes, and confidence about caring for lesbian, gay, bisexual and transgender patients: A cross-sectional survey. BMC Medical Education 21: 56.

Bachmann

Gooch

(2018) LGBT in Britain: Health Report. London: Stonewall.

Berner

Connolly

Pinnell

, et al. (2021) Attitudes of trans men and non-binary people to UK cervical screening. British Journal of General Practice 71(709): e614–e625.

General Medical Council (2018) Promoting excellence. Available at: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/promoting-excellence (accessed 15 June 2022).

Government Equalities Office (2018) LGBT survey summary report. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/722314/GEO-LGBT-Survey-Report.pdf?_ga=2.51981227.300164495.1566555469-619039795.1563360371

Government Equalities Office (2019) Health and Social Care and LGBT Communities. London: House of Commons, Women and Equalities Committee.

Manchester City Council (2015) Research Study Into the Trans Population of Manchester. Manchester: Manchester City Council.

McNamara

(2016) Best practices in LGBT care: A guide for primary care physicians. Cleveland Clinic Journal of Medicine 83(7): 531–541.

McNeil

Bailey

Ellis

, et al. (2012) Trans mental health study. Available from: https://www.scottishtrans.org/wpcontent/uploads/2013/03/trans_mh_study.pdf (accessed 4 January2022).

10.

Nowaskie

Sowinski

(2018) Primary care providers’ attitudes, practices, and knowledge in treating LGBTQ communities. Journal of Homosexuality 66(13): 1927–1947.

11.

Parameshwaran

Cockbain

Hillyard

, et al. (2016) Is the lack of specific lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) health care education in medical school a cause for concern? Evidence from a survey of knowledge and practice among UK medical students. Journal of Homosexuality 64(3): 367–381.

12.

Parliamentary Office of Science and Technology (2018) LGBT+ health and inequalities. Available at: https://spark.adobe.com/page/iISs8fqGJiVgI/ (accessed 4 January 2022).

13.

Salkind

Gishen

Drage

, et al. (2019) LGBT+ health teaching within the undergraduate medical curriculum. International Journal of Environmental Research and Public Health 16(13): 2305.

14.

Smith

Finn

Stewart

, et al. (2015) The anatomical society core regional anatomy syllabus for undergraduate medicine. Journal of Anatomy 228(1): 15–23.

15.

Somerville

(2015) Unhealthy Attitudes: The Treatment of LGBT People Within Health and Social Care Services. London: Stonewall.

16.

Van Der Vleuten

(1996). The assessment of professional competence: Developments, research and practical implications. Advances in Health Sciences Education: Theory and Practice 1(1): 41–67.