Comprehensive Curriculum for Internal Medicine Residents on Primary Care of Patients Identifying as Lesbian, Gay, Bisexual, or Transgender

Abstract

Introduction: Significant gaps remain in the training of health professionals regarding the care of individuals who identify as lesbian, gay, bisexual, and transgender (LGBT). Although curricula have been developed at the undergraduate medical education level, few materials address the education of graduate medical trainees. The purpose of this curriculum was to develop case-based modules targeting internal medicine residents to address LGBT primary health care. Methods: We designed and implemented a four-module, case-based, interactive curriculum at one university's internal medicine residency program. The modules contained facilitator and learner guides and addressed four main content areas: understanding gender and sexuality; performing a sensitive history and physical examination; health promotion and disease prevention; and mental health, violence, and reproductive health. Knowledge, perceived importance, and confidence were assessed before and after each module to assess curricular effectiveness and acceptability. General medicine faculty delivered these modules. Results: Perceived importance of LGBT topics was high at baseline and remained high after the curricular intervention. Confidence significantly increased in many areas, including being able to provide resources to patients and to institute gender-affirming practices (p < .05). Knowledge improved significantly on almost all topics (p < .0001). Faculty felt the materials gave enough preparation to teach, and residents perceived that the faculty were knowledgeable. Discussion: This resource provides an effective curriculum for training internal medicine residents to better understand and feel confident addressing LGBT primary health care needs. Despite limitations, this is an easily transferable curriculum that can be adapted in a variety of curricular settings.

Early Intervention for LGBTQ Health: A 10-Hour Curriculum for Preclinical Health Professions Students

“…Some of these publications describe more comprehensive activities but tend to focus on specific skills [38][39][40][41][42][43] or specific subpopulations of LGBTQ individuals, [44][45][46] and many are targeted toward learners at later stages of their training. 33,34,41,42,[45][46][47][48][49][50] Our curriculum represents a unique contribution by including a more comprehensive set of activities (including didactic presentations, case discussions, a community panel, and a session with standardized patients) that provide a general overview of LGBTQ-related health topics directed toward learners early in their training. Our curriculum is flexible and inexpensive to implement.…”

Teaching Sexual Orientation and Gender Identity in Pediatric Clinical Settings: A Training Workshop for Faculty and Residents

“… 2 , 11 Secondly, most interventions such as Gallego and Knudsen aim to only disseminate direct knowledge. 7 , 11 , 12 Our workshop was designed to provide faculty and resident the knowledge and skills needed to not only deliver appropriate care themselves, but also to teach sexual orientation and gender identity principles and LGTBQIA+ health to medical students and residents in clinical settings. Indeed, developing residents as teachers has become an emphasis.…”

Considerations for the Use of Minimally Invasive Aesthetic Procedures for Facial Remodeling in Transgender Individuals

“…Staff should be trained to address transgender patients using the patients’ preferred pronouns and identifiers, and intake forms should request information about “gender” rather than “sex,” with a write-in option for “other.” 4 The authors also recommend self-reflection for clinicians to ensure their own comfort with and acceptance of transgender patients before working with them, as well as improved professional training for healthcare providers to better understand and address the healthcare needs of transgender patients. 13 Otherwise, a lack of compassion or acceptance may subtly emerge during patient interactions, possibly to the detriment of patients’ psychological well-being.…”