LGBTQIA health in medical education: a national survey of Australian medical students.

PURPOSE: Lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA) individuals experience poorer health outcomes than other individuals. Insufficient LGBTQIA health education of doctors in existing medical curricula contributes to these outcomes. We sought to explore medical students' experiences of content coverage and mode of delivery, as well as their preparedness, attitudes and learning needs regarding LGBTQIA health education in Australia. METHODS: Using a conceptual framework specific to curricular development, we adapted a previous cross-sectional national survey. This included 28 questions (analysed statistically) and 5 free text responses (analysed deductively using Braun and Clarke's thematic analysis framework). Data was compared between LGBTQIA and non-LGBTQIA respondents, and clinical and preclinical students. RESULTS: There were 913 participants from 21 of 23 medical schools, with most preclinical (55%) and clinical (89%) students reporting no teaching specific to LGBTQIA health. Reported content coverage was highest for sexual history taking (30%), and especially low for transgender and intersex health (< 16%), and intersectional LGBTQIA health (< 7%). Participants had positive attitudes towards LGBTQIA health, with 89% agreeing LGBTQIA topics were important and need to be covered in detail. Students desired longitudinal integration of LGBTQIA content, and LGBTQIA community involvement and case-based teaching that allows for interaction and questions. Self-perceived competency was low in all LGBTQIA health topics, although LGBTQIA participants reported higher preparedness than non-LGBTQIA participants. CONCLUSIONS: Majority of survey participants reported limited teaching of LGBTQIA health-specific content, highlighting the limited coverage of LGBTQIA health in Australian medical schools. Participants expressed positive attitudes towards LGBTQIA content and broadly agreed with statements supporting increased integration of LGBTQIA health content within medical curricula.

Inclusion of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Health in Australian and New Zealand Medical Education.

PURPOSE: This study aims at establishing the scope of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) health in Australian and New Zealand medical curricula. METHODS: We sent medical school curriculum administrators an online cross-sectional survey. RESULTS: The response rate was 15 medical schools (71%): 14 Australian schools and 1 New Zealand school. Respondents included program directors (n = 5; 33%), course coordinators (n = 4; 27%), Heads of School (n = 2; 13%), one Dean (7%), and three others (20%). Most schools (n = 9; 60%) reported 0-5 hours dedicated to teaching LGBTQI content during the required pre-clinical phase; nine schools (60%) reported access to a clinical rotation site where LGBTQI patient care is common. In most schools (n = 9; 60%), LGBTQI-specific content is interspersed throughout the curriculum, but five schools (33%) have dedicated modules. The most commonly used teaching modalities include lectures (n = 12; 80%) and small-group sessions (n = 9; 60%). LGBTQI content covered in curricula is varied, with the most common topics being how to obtain information about same-sex sexual activity (80%) and the difference between sexual behavior and identity (67%). Teaching about gender and gender identity is more varied across schools, with seven respondents (47%) unsure about what is taught. Eight respondents (53%) described the coverage of LGBTQI content at their institution as "fair," two (13%) as "good," and two (13%) as "poor," with one respondent (7%) describing the coverage as "very poor." None of the respondents described the coverage as "very good." CONCLUSIONS: Currently, medical schools include limited content on LGBTQI health, most of which focuses on sexuality. There is a need for further inclusion of curriculum related to transgender, gender diverse, and intersex people.