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The Looming Crisis in Sexual Health Education

Think back on your training as a healthcare professional. How much of your formal education focused on sexual health? Did you take courses specifically in sexual health or were sexual health topics mixed in with other content? Were any courses in sexual health mandatory? Were they offered as electives?        

Now that you’re working in the healthcare field, do you feel well-trained to respond to sexual issues with your patients or clients?

It might be true that your practice doesn’t focus much on sexual health or that these issues just don’t come up that often. However, given that sexual health is an important part of overall health, it’s worthwhile to consider how much time medical schools devote to sexual health education.

There is some sobering news.

The Situation

In 2010, Galletly et al. reported in Academic Psychiatry (citing previous research) that less than half of American medical schools have formal sexual health curricula. Physicians don’t feel prepared to address sexual issues with patients, who are becoming less confident in their physicians’ abilities to help them with sexual complaints.

Galletly et al. found that there is little consensus among American medical schools on what sexual health information students should be expected to master. Many schools focus on only a few areas, usually sexually-transmitted infections and the effects of illness and medications on sexual function.

However, topics concerning healthy sexual function are not commonly addressed. The authors also noted that medical schools could offer strategies for conducting sexual health screenings during busy, time-compressed office visits.

In the case of content related to lesbian, gay, bisexual, and transgender (LGBT) patients, the news could be better. In a 2011 study published in the Journal of the American Medical Association, Obedin-Maliver et al. found that among 132 U.S. and Canadian medical schools, a median of just 5 instructional hours was devoted to LGBT topics.

“Our understanding of LGBT health issues is poor,” lead author Dr. Juno Obedin-Maliver told Shots, the health blog of NPR. “We don’t ask patients about it and we don’t perform research on it. We know little bits about some populations in certain settings, but it remains a hidden population and therefore a hidden health demographic.”

Dr. Obedin-Maliver is a resident physician in obstetrics and gynecology at the University of California, San Francisco.

What Can Be Done?

Colleagues at the Program in Human Sexuality at the University of Minnesota Medical School have suggested a sexual health education summit for medical school educators.

The summit’s goals would include:

·       Assessing the current state of sexual health education in U.S. and Canadian medical schools

·       Discussing strategies for improving sexual health education, such as determining how much training is necessary and which content areas are essential

·       Making recommendations for curricula that will properly prepare medical students to address their patients’ sexual concerns

·       Recommending a “comprehensive and integrated” sexual health curriculum that every U.S. and Canadian medical school can follow

At this time, a date for the summit has not been set.  Interested parties may contact Eli Coleman at the University of Minnesota at colem001@umn.edu.

What Can Individual Practitioners Do?

Even if you’re finished with medical school, there are still a variety of ways to learn more about sexual health.

·       Participate in continuing medical education (CME) programs and courses.

·       Attend conferences and seminars related to sexual health.

·       Join professional organizations or check their websites for informational materials geared to healthcare providers.

·       Stay up to date on sexual health news and research by reading peer-reviewed journals, such as the Journal of Sexual Medicine.

·       Talk to your colleagues. How have they handled sexual medicine topics in the past? What are they doing to learn more?

Over time, we can ensure a complete sexual health education for current medical students as well as practitioners already in the field.

Resources

Academic Psychiatry
Galletly, Carol, PhD, et al.
“Sexual Health Curricula in U.S. Medical Schools: Current Educational Objectives”
(September-October 2010)
http://ap.psychiatryonline.org/article.aspx?articleid=51882

Journal of the American Medical Association

Obedin-Maliver, Juno, MD, MPH, et al.
“Lesbian, Gay, Bisexual, and Transgender-Related Content in Undergraduate Medical Education”
(September 7, 2011)
http://jama.jamanetwork.com/article.aspx?volume=306&issue=9&page=971

Sexual Medicine Society of North America
“Summit on Medical School Education in Sexual Health”
http://www.sexhealthmatters.org/for-healthcare-providers/summit-on-medical-school-education-in-sexual-health

Shots (NPR)
Barclay, Eliza
“Med Schools Fall Short on LGBT Education”
(September 7, 2011)
http://www.npr.org/blogs/health/2011/09/07/140246309/med-schools-fall-short-on-lgbt-education