Canadian medical schools are not teaching new doctors enough about the unique health needs of lesbian, gay, bisexual and transgender patients, a new study suggests.
The average amount of time medical schools spend teaching students about health issues facing the LGBT community is about five hours over the entire curriculum, according to a study from the Stanford University School of Medicine published in the Journal of American Medical Association.
In the study, researchers submitted a web-based survey to 176 medical school deans in the U.S and Canada, receiving responses from 85 per cent. Of those, 11 of the participants were Canadian institutions.
Although many medical schools do address some LGBT-related health issues in their curricula, the conversation needs to go deeper, said the study's lead author, Dr. Juno Obedin-Maliver, of the University of California, San Francisco.
"These are misconceptions in the public at large and because there isn't specific education in medicine about it, doctors-in-training — who are just people in society — don't get disavowed of their social thinking about this group," she said.
Of the 150 survey respondents, 70 per cent described their school's coverage of 16 LGBT-related topics, like HIV and STIs, gender identity, and mental health issues, as "fair", "poor" or "very poor."
Ninety-seven per cent said their school teaches students to ask patients if they have sex with men, women, or both when taking a sexual history. Seventy-two per cent of schools stated their students are taught the difference between behavior and identity, like men who have sex with men but still identify as straight.
However, less than a quarter of respondents did not know whether the difference was taught.
Without adequate education, the study's authors suggest new doctors are often left with fallacies about lesbians and gays that are rampant throughout society.
"Many physicians out there still believe HPV and other STDs can't be transmitted from a woman to a woman, which is not true," she explained.
Another often-overlooked issue is lesbians, compared to straight women, tend to have higher rates of breast cancer as they tend to have fewer children. Research has linked having children as playing a role in reducing the risk of developing breast cancer, said Obedin-Maliver.
Understanding the specific health needs of LGBT people can only begin when a comfortable dialogue is established between physician and patient, said Obedin-Maliver.
"LGBT people don't necessarily feel comfortable talking openly about their life to a doctor, and that can lead to difficulties in treatment if you don't have accurate information," she explained. "But most patients will talk about things if their providers are really openly interested and wanting to learn from their patients."
The study's high survey response rate demonstrates medical schools are interested in improving the level of LGBT education offered in their curricula, said Dr. Raymond Curry, vice dean for education at Northwestern University's Feinberg School of Medicine in Chicago.
However, Curry, who wrote an editorial on the study, said the researchers' method of calculating hours spent on teaching LGBT-related issues in the curriculum avoids some key questions about campus culture.
"Are there educational leaders or course directors that are gay or lesbian, or that are clear allies who speak to the issue?" asked Curry. "Seeing what the range of responses would be, whether there are easily identifiable faculty that students can relate to has a lot to do with how open and free the discussion is about patients' issues."
As the survey asked medical school deans to self-evaluate their institutions, Obedin-Maliver said it is possible their perceptions could be slightly skewed.
"We expect people to round up, so it could be quite a bit worse even," she said.
Obedin-Maliver said she hopes the study's results yield a greater focus on including LGBT education in medical school curricula in the future.
"I think that this is a topic whose time has come," she said.