A Novel Curriculum for Medical Student Training in LGBTQ Healthcare: A Regional Pathway Experience

Abstract

Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face considerable health disparities, often due to a lack of LGBTQ-competent care. Such disparities and lack of access to informed care are even more staggering in rural settings. As the state medical school for the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region, the University of Washington School of Medicine (UWSOM) is in a unique position to train future physicians to provide healthcare that meets the needs of LGBTQ patients both regionally and nationally. Objective: To describe our methodology of developing a student-driven longitudinal, region-wide curriculum to train medical students to provide high-quality care to LGBTQ patients. Methods: A 4-year LGBTQ Health Pathway was developed and implemented as a student-led initiative at the UWSOM. First- and second-year medical students at sites across the WWAMI region are eligible to apply. Accepted Pathway students complete a diverse set of pre-clinical and clinical components: online modules, didactic courses, longitudinal community service/advocacy work, a scholarly project, and a novel clinical clerkship in LGBTQ health developed specifically for this Pathway experience. Students who complete all requirements receive a certification of Pathway completion. This is incorporated into the Medical Student Performance Evaluation as part of residency applications. Results: The LGBTQ Health Pathway is currently in its fourth year. A total of 43 total students have enrolled, of whom 37.3% are based in the WWAMI region outside of Seattle. Pathway students have completed a variety of scholarly projects on LGBTQ topics, and over 1000 hours of community service/advocacy. The first cohort of 8 students graduated with a certificate of Pathway completion in spring 2020. Conclusions: The LGBTQ Health Pathway at UWSOM is a novel education program for motivated medical students across the 5-state WWAMI region. The diverse milestones, longitudinal nature of the program, focus on rural communities, and opportunities for student leadership are all strengths and unique aspects of this program. The Pathway curriculum and methodology described here serve as a model for student involvement and leadership in medical education. This program enables medical students to enhance their training in the care of LGBTQ patients and provides a unique educational opportunity for future physicians who strive to better serve LGBTQ populations.

Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot

“…Additionally, allied healthcare professional education could take a regional approach and seek to foster competent and affirming care in rural settings [ 83 ]. For example, in their LGBTQ curriculum pathway, the University of Washington School of Medicine required students to engage in advocacy/community activities with rural LGBTQ+ organizations [ 83 ].…”

“…Additionally, allied healthcare professional education could take a regional approach and seek to foster competent and affirming care in rural settings [ 83 ]. For example, in their LGBTQ curriculum pathway, the University of Washington School of Medicine required students to engage in advocacy/community activities with rural LGBTQ+ organizations [ 83 ]. Indeed, while TEACHH took place in urban settings, rural care of trans women and trans women living with/affected by HIV is of critical importance, given studies showing perceived inadequacies in rural provider competency to provide affirming care and subsequent challenges faced by rural LGBTQ people, including higher rates of discrimination, lower likelihood of sexual/gender minority identity disclosure, and health disparities [ 84 ].…”

A Plea for Diversity in Eating Disorders Research

“…To the best of our knowledge, there are no diversity-oriented medical trainings that focus specifically on ED interventions or training. Some contemporary examples of diversity-oriented medical trainings have been evaluated at mostly North-American universities and institutions, although there are only a few examples of extensive curricula (99,100). Furthermore, diversity trainings of the kind are often offered separately from general education, usually geared toward specific minority groups, and offered voluntarily, thus bearing the risk that only a limited number of students (e.g., those with prior knowledge and interest in the subject, and the willingness to question their positions) will participate.…”

Teaching LGBT+ Health and Gender Education to Future Doctors: Implementation of Case-Based Teaching

“…One study reported that the LGBTQ Health Pathway program developed by a student-driven curriculum enables medical students to enhance their training in the care of LGBT+ patients. It also reported that the LGBTQ program enhanced medial students' interest in LGBT+-related medicine [28]. One study reported that increasing the amount of LGBT+ teaching in undergraduate medical curricula could increase medical students' awareness of LGBT health issues and increase positive attitudes towards LGBT+ patients [29].…”