Lesbian, Gay, Bisexual, and Transgender Health: a Survey of Attitudes, Knowledge, Preparedness, Campus Climate, and Student Recommendations for Change in Four Midwestern Medical Schools

Abstract

Medical school curricula addressing the unique healthcare needs and disparities of lesbian, gay, bisexual, and transgender (LGBT) patients are insufficient. National organizations have recommended curricular and institutional climate changes to address this problem. This study examined students’ perceived attitudes and knowledge regarding LGBT patient care and campus climate at four Midwestern US allopathic medical schools. During 2013, all medical students at the four institutions were invited to participate in the online anonymous survey. We used descriptive statistics for survey item results and qualitative methods to analyze responses to open-ended questions about curricular changes. Survey results were obtained from 34.6% of students and demonstrated that attitudes, knowledge, preparedness, and campus climate across all institutions were generally positive for LGBT patients and students. A negative correlation was found between overall campus climate and discrimination practices. Four themes emerged from students’ recommendations to improve their training, which included more clinical experiences with LGBT patients, more formal curricula on LGBT topics, establishment of safe learning environments, and addition of specific topics related to LGBT health. Due to the low prevalence of LGBT populations, reluctance to disclose sexual orientation or gender identity, and lack of LGBT-specific clinics, required experiences with LGBT patients during clinics or clerkship rotations may be more difficult in smaller urban communities in which some Midwestern medical schools are located. Potential alternatives include using multiple teaching modalities in the pre-clerkship years to expose students to LGBT-identified patients in clinical simulations and settings