How do UK medical graduates rate their knowledge and skills in sexual health and HIV medicine? A national survey

Abstract

The objectives of this study are to determine self-assessed knowledge and skills in sexual health and HIV medicine in preregistration house officers and to explore undergraduate experiences of teaching and assessment in these subjects prior to the launch of National Core Learning Outcomes in Sexual and Reproductive Health and HIV. The study was designed as a postal questionnaire survey. The participants were all UK medical graduates of August 2004. The response rate 1737/4746 (36%). The main outcome measures were Doctors' views on their preparedness to manage patients with sexual health and HIV-related problems. Since graduation, 90% of respondents had seen at least one patient with a sexually transmitted infection or HIV-related issue. Seventy-six percent felt confident to take a sexual history. In all, 63% and 53% felt competent in male and female genital examination, respectively. Forty-three percent felt they could conduct an appropriate HIV pretest discussion and 59% felt they could recognize clinical indicators suggestive of HIV. Seventy-eight percent had been formally assessed in sexual health and 55% in HIV medicine. Increased confidence in sexual history taking, HIV pretest discussion and recognition of HIV indicators was associated with a longer duration of teaching and formal examination. In conclusion, although the proportion of recent graduates confident in sexual history taking is encouraging, their lack of skill in discussing HIV testing, risk assessment and recognition of possible HIV presentations must be addressed. Integration of National Core Learning Outcomes into all undergraduate curricula is a key step in reducing inconsistencies in undergraduate training.

Development, implementation, and evaluation of a student-initiated undergraduate medical education elective in HIV care

“…Studies of medical students, residents, and practicing physicians have documented that HIV risk behavior continues to go unidentified, and that counseling on HIV prevention is ineffective (Curtis et al 1994;Cook et al 1998;Liddicoat et al 2004). A survey of British medical graduates found that less than 45% felt that they could conduct an appropriate HIV pre-test discussion, and less than 60% felt that they could recognize clinical indicators suggestive of HIV (Estcourt et al 2009). This competency is especially relevant given that many individuals are unaware of their HIV infection.…”

An audit highlighting a lack of awareness of the UK national guidelines for HIV testing, 2008

“…However, possibly more concerning is that in a recent survey of UK junior doctors, who graduated in 2004, less than half of them felt they could conduct an appropriate HIV pre-test discussion and only 59% felt confident that they could recognize clinical indicators suggestive of HIV. 6…”

What do GUM physicians think should be taught in a modern undergraduate GUM module? A qualitative inquiry

“…[9][10][11] Yet, evidence indicates that education in sexual health appears to increase physician willingness to manage such concerns. [12][13][14] Similarly, educational interventions can improve provision of care for HIV patients, both in terms of healthcare worker knowledge and attitudes. 15 Thus, one necessity for the interruption of the current STI and HIV pandemics is education of physicians in their management.…”