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Medical Students and LGBTTQI Issues

The Society of Obstetricians and Gynecologists of Canada policy statement on Lesbian Health[1] notes that education regarding health care issues of lesbian and gay patients must begin in medical school. Most medical training either ignores or inadequately addresses LGBTI health care issues[2]. In one survey of 324 lesbians, 20% believed their primary care provider to have insufficient knowledge of lesbian health issues[3]. This concern was echoed in a focus group study of 32 lesbian women, who felt that there was a lack of clinical research to guide them in their health care and that physicians were not trained in lesbian health issues[4].

In addition to ensuring the wellbeing of patients by providing training in LGBTI health issues, the inclusion of these issues in medical training might help to improve the atmosphere at medical schools and in practice for gay, lesbian, transgendered and intersex physicians. By ignoring these issues, LGBTI patients become invisible and their health concerns are ignored, and as a parallel to this, LGBTI physicians and medical students are also rendered invisible. Burke and White[5] reviewed what few studies have been published about the wellbeing of gay, lesbian and bisexual doctors, and found that there is documented homophobia among physicians and in medical schools, and that gay, lesbian and bisexual doctors experience verbal harassment from colleagues.

McGarry et al.[6] evaluated a lesbian and gay health care curriculum for internal medicine residents consisting of a 3-hour seminar on gay and lesbian health including a video, lecture and case discussion, and both a pre- and post-seminar survey. They concluded that the seminar had a positive impact, resulting in the residents being more comfortable and prepared to deal with homosexual patients. In addition, 100% of the residents felt that it was important to learn about gay and lesbian health issues.

Ultimately, both the health care system and medical training needs to be inclusive of, and responsive to, the health care needs of all Canadians, including the LGBTI population[7]. The studies discussed above[4] [6] illustrate the importance of including LGBTI health care issues in medical curriculum in order to ensure that physicians are knowledgeable and comfortable dealing with all patients.

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1. Davis V, Christilaw JE, Edwards C, Francoeur D, Grant LJ, Parish B, Saraf-Dhar R, Steben M. SOGC Clinical Practice Guidelines. Policy Statement No. 87. Lesbian Health Guidelines. Journal of the Society of Obstetricians and Gynecologists of Canada. 2000;22(3):202-205. http://sogc.medical.org/SOGCnet/sogc_docs/common/guide/pdfs/ps87.pdf. Accessed on July 18, 2003.

2. Kaiser Permanente National Diversity Council. A Provider's Handbook on Culturally Competent Care: Lesbian, Gay, Bisexual and Transgendered Population. Oakland, CA. Kaiser Permanente; 2000.

3. White JC, Dull VT. Room for Improvement: Communication between Lesbians and Primary Care Providers. In Ponticelli CM, Ed. Gateways to Improving Lesbian Health and Health Care: Opening Doors. 1998. The Haworth Press, Inc. Binghamton, NY. pp. 95-110.

4. Barbara AM, Quandt SA, Anderson RT. Experiences of lesbians in the health care environment. Women & Health. 2001;34(1):45-62.

5. Burke BP, White JC. Wellbeing of gay, lesbian and bisexual doctors. British Medical Journal. 2001;322:422-425.

6. McGarry KA, Clarke JG, Cyr MG, Landau C. Evaluating a lesbian and gay health care curriculum. Teaching and Learning in Medicine. 2002;14(4):244-248.

7. Hudspith M. Caring for Lesbian Health: A Resource for Canadian Health Care Providers, Policy Makers and Planners, Revised Edition. 2001. Health Canada. http://www.hc-sc.gc.ca/english/women/facts_issues/lesbian_health.htm. Accessed October 24, 2003.

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