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Summit on Medical School Education in Sexual Health


Sponsored by
Program in Human Sexuality
Department of Family Medicine and Community Health
Medical School
University of Minnesota

Supported by the Joycelyn Elders Chair in Sexual Health Education

The Problem:  A Crisis in Medical School Education in Sexual Health

In 1997, Marian Dunn completed a survey on trends in sexuality education in United States and Canadian medical schools and reported a cautious but encouraging trend.
 
In a more recent study in 2003, Solursh et al reported a more sobering report that most medical schools provide only 3–10 hours of instruction. Of 101 medical schools who responded to their survey, human sexuality was taught as a course in only 31 schools and was required by 26 of them. Most schools did not provide specific clinical programs or continuing medical education.
 
I fear that if a survey was conducted today – that the number of courses has declined.
 
In a study in 2010, Gallety et al  reported that in examining sexual health curricula, there was no consensus about many of the attitudinal objectives and some of the skills medical students should acquire in sexual health. There was less consensus on the sexuality-related information student physicians need to master. The few common informational objectives focused narrowly on diagnosing sexual dysfunction and disease. They concluded that the model sexual health curricula, licensing exams, and guidelines from professional organizations mainly focus on the pathological aspects of sexuality. They recommended that student physicians should master fundamental information on healthy sexual function and become familiar with the roles of practitioners in various therapeutic disciplines in addressing sexual concerns and enhancing patients’ sexual functioning and well-being. Instruction should also address ways to incorporate this important topic in time-limited interactions with patients. Abstract Teaser
 
Most recently, in a study published in 2011 in JAMA, Obedin-Maliver et al reported that the median reported time dedicated to LGBT-related content in medical school in 2009-2010 was 5 hours, but the number of hours in the required curriculum, as well as number of LGBT-related topics covered, varied widely. In many schools, deans of medical education endorsed dissatisfaction with their institutions’ coverage of LGBT-related topics and provided potential strategies for increasing curricular content.  
 
Recently, there has been a push for more sexual diversity training – albeit insufficient – but general training in sexual health may have suffered even more.
 
Meanwhile there are major shifts occurring in overall medical school curricula today. There is a move away from stand-alone courses and a push for more integrated learning.  This puts whatever sexual health education at risk at most medical schools and my anecdotal observation is that we are losing ground.  There is more opportunity for integrating sexual health into the mainstream courses – yet there is a need for a model for doing so and major faculty development efforts are needed.
 
At the same time, the need for preparation of medical students to be able to attend to the myriad of sexual health problems faced by their patients is very clear.  We have a public health imperative to address these problems.
 
There are many questions:
  • Is there still a need for a stand alone course in human sexuality?
  • How much training is needed?
  • What are the best methods for teaching this type of course?
  • Beyond sexual history taking, what are the essential content areas?
  • What should be required and what should be elective?
  • Recognizing that sexual health should be taught in an integrated and longitudinal fashion, what is the best model for delivering that curriculum?
 
In this shifting climate of sexual health curricula, no model of how to fit sexual health into the “new” curricula has been established. 
 
Summit Purpose:
 
This sexual health education summit will gather key US and Canadian medical school educators in sexual health education, medical school educators, and interested parties at the federal level (CDC, HRSA) to examine the situation, discuss the challenges and opportunities, share lessons learned, and make recommendations for insuring that physicians are properly trained to address the sexual health needs of their patients when they go out in practice.  This will involve recommending a comprehensive and integrated sexual health curriculum that should be put into place in every US and Canadian medical school.  This summit and meeting report will serve as a catalyst for re-invigorating the necessary sexual health curriculum to meet the needs of physicians of the future.  
 
Format:  1 ½ days.  Leaders will be invited to review a commissioned background paper on the state of sexual health education in the US and Canada and recommended curriculum changes.  Each of the invited speakers will share their perspectives in a think-tank format with brief presentation followed by extensive discussion.  Interested parties will be invited as observers and will be permitted to ask questions and make comments at certain intervals of the process.  A meeting report will be prepared and disseminated to interested parties and key stakeholders.  
 
If interested, contact Eli Coleman at colem001@umn.edu