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A New Student-Designed LGBTQIA+ Health Curriculum at the University of Michigan Medical School

As almost-graduated M4s at the University of Michigan Medical School (UMMS) we have had a lot of exposure to the full breadth of the curriculum from the foundational Scientific and Clinical Trunks during our M1 and M2 years all the way up to the broad elective time in the Branches during our M3 and M4 years. We feel so fortunate that we were both able to develop a strong foundation early on and have the time to explore our own areas of interest later in the curriculum. However, as we moved through the curriculum, one area that we hoped to have more exposure to was LGBTQIA+ health.

As is true for many medical schools across the country, coverage of topics relating to LGBTQIA+ health in medical curricula can feel sparse and disjointed. At the time that we both matriculated, UMMS had existing LGBTQIA+ health teaching during a couple of required sessions in the M1 and M3 Doctoring curriculum, as well as through the optional Transgender Health elective that can be taken in the Branches. While these sessions were certainly necessary and beneficial, we felt that a more comprehensive and cohesive course covering foundational and advanced topics relating to LGBTQIA+ patient care would be highly valuable for UMMS students.

In addition to our own personal experiences with the UMMS curriculum, we also participated in a research effort in collaboration with Dr. Dustin Nowaskie, a current faculty member at Keck School of Medicine and Founder and President of OutCare Health. Through this study, 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. Driven by this, we led the effort to create a new course titled “Introduction to LGBTQIA+ Health”.

Taking advantage of flexibility in the Branches phase of the curriculum, in addition to the resources available to us via the Capstone for Impact program, we embarked on a nearly one-year journey of developing this novel curriculum. Under the invaluable mentorship of Dr. Julie Blaszczak in the Department of Family Medicine, we brainstormed any and all topics relating to LGBTQIA+ health that a future physician would find useful in caring for a LGBTQIA+-identified patient. Through many weeks of revisions and gathering outside input, we decided that this course would fit best as a two-week, online elective and would cover a broad range of topics in nine distinct modules building from basic, foundational concepts and ending in specialty-specific care topics.

Foundational Concepts, General Clinical Skills, Specialty-Specific Topics

Overview of the nine modules of the course: Starting from basic foundational concepts, moving to general clinical skills, and finishing with relevant LGBTQIA+ care topics in different specialties.

In order to make the course as engaging as possible, we incorporated a variety of learning modalities including required readings, journal articles, podcasts and videos. We also reached out to content experts at our institution and across the country to record lectures, which we embedded into the course. Through OutMD, our LGBTQIA+-focused student group, we also recruited other medical students to help with construction of each of the nine course modules.

After many hours of hard work in planning, designing and building these modules, our team is so proud that this course is up and running for UMMS students to take during their M3 and M4 years in the Branches! From initial data taken from students who have completed the course, we were able to show that students have higher basic knowledge in this area and are more clinically prepared and confident in the care of LGBTQIA+ patients.

We are ecstatic about how this course has turned out, and we hope that it has a lasting positive impact on future UMMS students. More and more people in the U.S. are identifying as LGBTQIA+ and as such we as future physicians have a responsibility to provide the most competent and informed care possible to this growing subset of the population. We hope that this course bridges a gap in medical education and will overall make UMMS graduates more able and comfortable in delivering healthcare to LGBTQIA+ patients.


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.

Hannah Glick (left) and Anuj Patel (right) are leading the effort to create the first ever LGBTQIA+ Health elective at the University of Michigan Medical School.

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!!