Pride in Practice: Enhancing LGBTQIA+ Health Education at Michigan Medical School

LGBTQIA+ people face a number of challenges in everyday life, including many health disparities. On average, LGBTQIA+ persons have higher rates of many chronic diseases and poor physical and mental health compared to cisgender and/or straight people. In addition, micro and macro aggressions when seeing a doctor are all too common for LGBTQIA+ people, whether that be in the form of non-inclusive intake forms or insensitive history taking or physical exams by physicians. When we started medical school as new M1s, and as members of the LGBTQIA+ community ourselves, we were acutely aware of this fact and were resolved to learn more about these health disparities from our patients and our curriculum, as well as seek and create methods to combat them.

In our M1 year, both of us were immensely grateful to have had the opportunity to serve on the leadership team for OutMD, our LGBTQIA+ medical student group at the University of Michigan. OutMD provided us a community of like-minded, queer medical students who were passionate about LGBTQIA+ health. Through our gatherings and monthly lunch talks, OutMD allowed us to learn about a number of topics in LGBTQIA+ health, including transgender hormonal care, LGBTQIA+ health policy, and primary care.

 As medical students at the University of Michigan, we have a unique ability to incorporate our passions, like LGBTQIA+ health, into our education through curricular and extracurricular activities. However, while we were able to easily organize learning about these important topics extracurricularly, we felt that there was not nearly enough LGBTQIA+ health education embedded within our medical school curriculum.

 As part of a collaboration with Dr. Dustin Nowaskie at IU School of Medicine and OutCare Health, we conducted a research project on LGBTQIA+ health medical education where we learned that medical students may need as many as 35 hours of curricular education in order to ensure high levels of LGBTQIA+ cultural humility in patient care. Michigan medical students were receiving far fewer hours than this benchmark. Driven by this gap, we aimed to create a new LGBTQIA+ Health elective for our medical curriculum as our Capstone For Impact project: a unique part of our curriculum which encourages students to reflect on their interests and passions, and to determine a project which results in a positive impact upon health, health care, and/or health systems.

In the Branches (as third- and fourth-year students) we are allotted ample flexibility to schedule a variety of clinical and non-clinical electives for in-person and online formats. Knowing this, we set a goal to create a new two-week, fully online Introduction to LGBTQIA+ Health elective for students to participate in during their third and fourth years. While creation of our curriculum is just getting underway, we have already received tons of support! We are lucky to be surrounded by brilliant faculty like our Capstone Advisor, Dr. Julie Blaszczak who is a member of the Family Medicine Department and an expert in LGBTQIA+ Health. She has been instrumental in supporting us to get this project off the ground. With the timeline we have in place, we are hoping to start offering this course to students in the Branches by 2022.

Our hope is that this new course will offer our fellow medical students a broad, comprehensive introduction to LGBTQIA+ health care. We plan to include a number of modules in our course that will cover basic background, language, and definitions, relevant history and policy, health disparities, clinical skills, and specialty topics in the care of LGBTQIA+ patients with input from faculty in primary care, psychiatry, pediatrics, Ob/Gyn, urology, plastic surgery, ENT, and dermatology. We plan to incorporate a number of different learning media including graphics, recorded presentations from content experts, news and research articles, and other existing resources.

We are incredibly excited and grateful to have the time and the support to incorporate our passion for LGBTQIA+ health into the curriculum at UMMS. We feel that this elective will leave an important and lasting impact on the UMMS curriculum and is a critical step in creating a new generation of LGBTQIA+ sensitive and competent physicians. Happy Pride!!