Let's Talk About Sex
Creation of a Novel Sexual Health Elective and Sexual Health Elective for Medical Trainees
CFI project lead: Reni Forer
CFI advisor: Julie Blaszczak, MD, MEHP, Clinical Assistant Professor of Family Medicine
Sexual health is an important part of patient care, yet many medical trainees report feeling underprepared to address patients’ sexual concerns. A 2023 needs assessment of University of Michigan medical students found that 76% were dissatisfied with the amount of sexual health education they received, and only half were satisfied with its quality. These findings highlighted a clear need for more comprehensive training in sexuality and sexual health.
To address this gap, the team created “Sexual Health: Beyond the Basics,” a two-week online elective for medical trainees. The course is designed to increase awareness of topics related to sexuality, sexual health and common sexual concerns, while also improving learners’ confidence and competence in caring for diverse patient populations. The elective includes 27 modules and more than 40 hours of asynchronous content delivered through expert lectures, written materials, podcasts, published articles and other multimedia resources.
The course was initially offered to upper-level medical students at the University of Michigan Medical School, with plans to expand access to residents and practicing physicians at Michigan Medicine and beyond. It was piloted from February to August 2025 and approved as a permanent elective in October 2025. As of January 2026, 21 students have completed the course, with 18 more scheduled through August 2026.
Evaluation of the pilot course showed meaningful improvements in students’ confidence and knowledge related to sexual health. Using a validated assessment tool, students demonstrated significantly higher post-course scores in confidence, knowledge and overall preparedness. Qualitative feedback was also positive, with students reporting greater comfort discussing sexual concerns with patients.
By addressing a long-standing gap in medical education, “Sexual Health: Beyond the Basics” helps prepare future physicians to provide more informed, inclusive and patient-centered sexual health care.
Topic areas: Quality Improvement, Health Equity
Q&A with Reni Forer
In what ways did this project influence your academic or career goals?
I have been interested in sexuality and sexual health for a long time and was excited to learn about these topics from a medical perspective when I matriculated. However, by the end of my M2 year, I was struck by the lack of time and depth devoted to these subjects in our medical school curriculum. As I explored the literature about sexual health education at other medical schools, I realized the lack of attention paid to these topics was widespread. This is what motivated me to create the “Sexual Health: Beyond the Basics” elective. It also has significantly shaped my academic and career goals.
I believe high-quality sexual health education is an essential component of medical training (both undergraduate, graduate and continuing education), particularly given the dearth of medically accurate sex education in U.S. public schooling. Many students enter medical school with minimal foundational knowledge and receive little additional preparation before entering clinical practice. While some specialties address sexual concerns more frequently than others, all physicians should feel comfortable discussing basic sexual health concerns and know when to refer patients for specialized care. Yet research suggests this standard is not consistently met.
I plan to continue addressing this educational gap throughout my career. As a future psychiatrist, I am in a unique position to advocate for improved training in this area while deepening my own expertise in sexual function and dysfunction, sex and relationship therapy and compassionate communication about sensitive and stigmatized topics. This project was integral to these goals by increasing my confidence in my abilities as an educator, connecting me with a network of others interested and engaged in sexual health, and motivating me to further my own education in these topics.
What challenges did you face during your CFI project, and how did you address them?
One of the main challenges I faced during my CFI project was imposter syndrome. As a student with no prior formal training in medical or sex education, I initially questioned if I was the right person to lead this work. However, I simultaneously felt strongly that change was needed and saw few others addressing the issue. I addressed my uncertainty by intentionally building strong mentoring relationships and expanding my own training. I was fortunate to receive mentorship from Dr. Julie Blaszczak, whose expertise in medical education guided development of the course, and from Mieke Beckman, a certified sex therapist who reviewed all materials for accuracy and appropriateness. In parallel, I sought to improve my own education, completing certificates in sexuality education and counseling through the Sexual Health Certificate Program at the University of Michigan School of Social Work. I also invited experts from across the country to contribute lectures, recognizing both the value of diverse perspectives and the limitations in my own expertise. Through this process, I learned to see my limitations not as a weakness, but as an opportunity to build partnerships and strengthen the final product.
What skills did you develop while working on your project, and how might these skills benefit your future career?
Through working on this elective, I developed skills in curriculum design, educational research, interdisciplinary collaboration and leadership that will directly inform my future career as a physician, medical educator and psychiatrist. Designing an elective with such a large amount of educational content required me to synthesize complex literature and multiple sources into accessible educational materials. Reading and learning so much about these topics while working on the elective also increased my own ability, confidence and comfort in discussing stigmatized topics in a clear and sensitive way with both patients and peers. Conducting pre- and post-course evaluation using validated instruments enhanced my skills in research design, data analysis, and critical appraisal, which will support my continued involvement in academic psychiatry and medical education. I also learned to coordinate a diverse group of expert and student contributors from across the country, which increased my skills in leadership, management of long-term projects, and setting boundaries. Together, all of these skills will help me care for patients with sexual and mental health concerns in a compassionate, evidence-based manner while also positioning me to advocate for and contribute to improved psychiatric and medical education.
What was the most rewarding aspect of your CFI project, and why was it meaningful to you?
The most rewarding aspect of this project thus far has been witnessing early student feedback, which has been overwhelmingly positive. After years of developing the elective, it was deeply gratifying to see students taking the course and read their anonymous reflections on its impact. Students have consistently described their sense of increased confidence and comfort in communicating with patients about sexual health, affirming that the course is addressing a meaningful gap in their training. Seeing this tangible effect on learners has made the long development process feel worthwhile and reinforced my commitment to continuing this work.
If you could repeat your CFI project, what would you change to improve the outcomes or process?
If I could repeat my CFI project, the only thing I would change is that I would have made the pre- and post-course survey mandatory from the beginning. We initially chose to make it optional but quickly realized that very few students were filling it out — meaning it would take years to collect enough data to know if the course was having an appropriate impact or not. As soon as we made it mandatory, we were able to tangibly evaluate the course and see its positive impact. This change also has made me more confident that we will be able to quickly address any mistakes or constructive feedback provided by students when it occurs.
What advice would you offer to future students starting a CFI project, based on your experience?
I would suggest starting early and making your project something you are truly passionate about! I had SO much fun working on this elective and plan to stay involved even after I graduate. That would not have been possible if I held off on working on it until my M3/M4 year. And it definitely would not have been such an amazing experience if the project was something I wasn’t genuinely excited to work on in my non-clinical free time.
I also would encourage students to seek mentorship from health care providers (and others) across disciplines, institutions and professional degrees (e.g. nursing, social work, etc.). That was a huge boon to me and this project and I’m so lucky to have had diverse perspectives to guide me in this effort.
