Successful implementation of an LGBTQI health elective into a medical school curriculum: a tool to increase culturally-sensitive care in person-centered medicine

Abstract

Most US medical schools do not yet include gender and sexual diversity in pre-clinical curricula and lack formal training in the medical care of Lesbian, Gay, Bisexual, Trans, Intersexed and Queer (LGBTIQ) patients.  This paper describes the design, implementation and evaluation of a student-led pre-clinical elective to address such deficiencies at one institution.  After formally assessing curricular gaps, two medical students designed a semester-long course consisting of eight lecture-discussion sessions taught by volunteer community physicians and activists, accompanied by reading and written assignments.  In the inaugural year of the course, the response rate for written anonymous evaluations by student participants was 81.2% (n=29).  Quantitative and qualitative evaluations of both individual sessions and the course were extremely positive.  In spite of initial educational challenges and limitations that have since been addressed, including lecture overlap and a self-selected audience, the course has thus far proved sustainable. The curriculum intervention achieved its further goals of institutional recognition of the need for LGBTIQ education and providing a model to integrate elective material into the standard curriculum. This paper provides medical students, faculty and administrators with a medical education pre-clinical curriculum development template for addressing other curricular content gaps at their own institutions, particularly for medically under-served populations. As such, it is advanced as an important contribution to the advancement of culturally-sensitive clinical practice, a key component of person-centered medicine.