An audit of the medical pre-clinical curriculum at an urban university: sexual and gender minority health content

Abstract

Most medical students receive inadequate preparation to care for sexual and gender minority (SGM) patients. A review of one urban medical school's pre-clinical curriculum was conducted to assess coverage of appropriate SGM health content. Curricula that fully or partially addressed American Association of Medical Colleges (AAMC) core competencies for SGM health were categorized in an Excel spreadsheet. For partially met competencies, content that addressed the competency along with what was needed to fully address the competency were documented. AAMC SGM competencies that were not addressed at all were also noted. As a secondary source for triangulation, curricular topics were compared to SGM health content prioritized by Vanderbilt, a leader in championing inclusion of SGM content in medical curricula. Of the 30 AAMC competencies, 10 competencies were addressed, 11 were partially addressed, and 9 were not addressed. Gaps were noted in the AAMC domains of professionalism, systems-based practice, interprofessional collaboration, and personal/ professional development. Among Vanderbilt topics, the George Washington University (GW) curriculum lacked content in intersex health, sexually transmitted infections (STIs) in lesbians, vaginitis in lesbians, efficacy of anal microbicides, anal Pap smears, and anal cancer risk and treatment for men who have sex with men (MSM). Despite these weaknesses, GW clocked greater than the national average at 7.5 hours of SGM content. This study provides a roadmap for curricular enhancements needed at GW as well as a prototype for other institutions to audit and improve curricular coverage on SGM health.

LGBTQ+ health education for medical students in the United States: a narrative literature review

“…Six articles (4.5%) evaluated the LGBTQ+ health content in existing curricula. Common tools for pre-clinical and/or clinical curriculum evaluations included the 2014 AAMC competencies [ 4 , 14 , 15 , 17 ] and learning objectives from Vanderbilt University [ 14 , 17 ]. Additionally, a team at Boston University developed the Sexual and Gender Minority Curriculum Assessment Tool (SGM-CAT) [ 19 ] based on the AAMC competencies [ 4 ] and used this to evaluate their curriculum [ 19 ].…”

“…Using the 2014 AAMC competenecies [ 4 ], two articles evaluated their school’s pre-clinical curriculum [ 14 , 17 ] and one the pre-clinical and clinical curriculum [ 15 ]. Among these articles, fifteen [ 14 ] and twenty-one [ 17 ] of the 30 competencies were partially or fully met in the pre-clinical curricula of two programs, and the pre-clinical and clinical curriculum at a different institution was found to address thirteen [ 15 ] of the 30 competencies. Two articles evaluated their pre-clinical curriculum using 31 learning objectives developed by Vanderbilt University in addition to the AAMC competencies [ 14 , 17 ].…”

“…Among these articles, fifteen [ 14 ] and twenty-one [ 17 ] of the 30 competencies were partially or fully met in the pre-clinical curricula of two programs, and the pre-clinical and clinical curriculum at a different institution was found to address thirteen [ 15 ] of the 30 competencies. Two articles evaluated their pre-clinical curriculum using 31 learning objectives developed by Vanderbilt University in addition to the AAMC competencies [ 14 , 17 ]. These articles found their pre-clinical curricula to fully address twelve [ 14 ] and twenty-two [ 17 ], and partially address seven [ 14 ] and five [ 17 ], of the learning objectives.…”

“…Two articles evaluated their pre-clinical curriculum using 31 learning objectives developed by Vanderbilt University in addition to the AAMC competencies [ 14 , 17 ]. These articles found their pre-clinical curricula to fully address twelve [ 14 ] and twenty-two [ 17 ], and partially address seven [ 14 ] and five [ 17 ], of the learning objectives. One article detailed the development of a 12-topic curriculum assessment tool based on the 30 AAMC competencies, named the SGM-CAT, which was then used to evaluate the pre-clinical and clinical curriculum at the institution [ 19 ].…”

“…However, there remains work to be done in this field in order to fully address all recommended competencies. Across all reviewed articles, 5 school evaluated their full pre-clinical and/or clinical curriculum [ 14 , 15 , 17–19 ]. Three institutions [ 14 , 15 , 17 ] specifically used the AAMC competencies in their evaluations [ 4 ].…”