title: Lesbian, Gay, Bisexual, and Transgender Patient Care: Medical Students' Preparedness and Comfort.
abstract: Phenomenon: Lesbian, gay, bisexual, and transgender (LGBT) individuals face significant barriers in accessing appropriate and comprehensive medical care. Medical students' level of preparedness and comfort caring for LGBT patients is unknown.
  
  
  METHODS
  An online questionnaire (2009-2010) was distributed to students (n = 9,522) at 176 allopathic and osteopathic medical schools in Canada and the United States, followed by focus groups (2010) with students (n = 35) at five medical schools. The objective of this study was to characterize LGBT-related medical curricula, to determine medical students' assessments of their institutions' LGBT-related curricular content, and to evaluate their comfort and preparedness in caring for LGBT patients.
  
  
  RESULTS
  Of 9,522 survey respondents, 4,262 from 170 schools were included in the final analysis. Most medical students (2,866/4,262; 67.3%) evaluated their LGBT-related curriculum as "fair" or worse. Students most often felt prepared addressing human immunodeficiency virus (HIV; 3,254/4,147; 78.5%) and non-HIV sexually transmitted infections (2,851/4,136; 68.9%). They felt least prepared discussing sex reassignment surgery (1,061/4,070; 26.1%) and gender transitioning (1,141/4,068; 28.0%). Medical education helped 62.6% (2,669/4,262) of students feel "more prepared" and 46.3% (1,972/4,262) of students feel "more comfortable" to care for LGBT patients. Four focus group sessions with 29 students were transcribed and analyzed. Qualitative analysis suggested students have significant concerns in addressing certain aspects of LGBT health, specifically with transgender patients. Insights: Medical students thought LGBT-specific curricula could be improved, consistent with the findings from a survey of deans of medical education. They felt comfortable, but not fully prepared, to care for LGBT patients. Increasing curricular coverage of LGBT-related topics is indicated with emphasis on exposing students to LGBT patients in clinical settings.
authors.affiliation: a Lesbian, Gay, Bisexual, & Transgender Medical Education Research Group, Stanford University School of Medicine , Stanford , California , USA.
authors.forename: William
authors.initials: W
authors.lastname: White
authors.forename: Stephanie
authors.initials: S
authors.lastname: Brenman
authors.forename: Elise
authors.initials: E
authors.lastname: Paradis
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Goldsmith
authors.forename: Mitchell R
authors.initials: MR
authors.lastname: Lunn
authors.forename: Juno
authors.initials: J
authors.lastname: Obedin-Maliver
authors.forename: Leslie
authors.initials: L
authors.lastname: Stewart
authors.forename: Eric
authors.initials: E
authors.lastname: Tran
authors.forename: Maggie
authors.initials: M
authors.lastname: Wells
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Chamberlain
authors.forename: David M
authors.initials: DM
authors.lastname: Fetterman
authors.forename: Gabriel
authors.initials: G
authors.lastname: Garcia
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001727:Bisexuality; D005260:Female; D017144:Focus Groups; D018452:Homosexuality, Female; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D005791:Patient Care; D013337:Students, Medical / Q000523:psychology*; D063106:Transgender Persons; D055815:Young Adult
keywords: and comfort; bisexual; gay; lesbian; patient care; transgender health