Sexual Health Curriculum and Training in Canadian Medical Schools: A Study of Family Medicine, Obstetrics and Gynaecology and Undergraduate Medicine Programs in 2011 with Comparisons to 1996
Barrett, Michael, McKay, Alexander, Dickson, Catherine, Seto, Joyce, Fisher, William, Read, Ron, Steben, Marc, Gale-Rowe, Margaret, Wong, Tom, The Canadian Journal of Human Sexuality
Abstract: This study examined the level of emphasis (topic not taught, minimal, considerable, heavy) placed on 18 sexual health topics within family medicine, obstetrics and gynecology, and undergraduate medicine programs at Canadian medical schools. Forty-one of 51 programs contacted (80.4%) returned usable questionnaires. For the three disciplines combined, the topics most likely to receive considerable or heavy emphasis were information and skills for contraception (97.6%), information and skills for prevention of STIs (75.6%), sexual violence/assault (73.2%), and female sexual dysfunction (73.2%). The topics least likely to receive considerable or heavy emphasis across disciplines were childhood sexuality (17.1%), sexuality and disability (22.0%), sexuality and aging in males (24.4%), and social and cultural differences in sexual beliefs and customs (26.8%). Findings are presented specifically for each discipline. The current study was designed to replicate a 1996 survey of sexual health training in Canadian medical schools and direct comparisons of the 2011 and 1996 results are reported here.
Sexual health is a fundamental aspect of overall health and well-being. Consequently, it is important that physicians are adequately trained to address sexuality and sexual health in practice. Parish and Clayton (2007) suggest that within medical school training in the United States, "Sexual health education is an example of an often neglected, but very important topic. Sexuality is important to almost all patients; yet this topic is not adequately represented in most undergraduate and residency training programs" (p. 259).
There is little current information available on the emphasis given to different sexual health topics in the training provided in Canadian medical schools. Nearly a decade and a half ago, Barrett and McKay (1998) provided detailed data on the emphasis placed on 19 sexual health topics in Canadian residency programs in family medicine, obstetrics and gynaecology, urology and psychiatry and in undergraduate medicine. The authors collected that data in 1996 and to our knowledge that is the only existing study in which topic emphasis was assessed at this level of specificity.
Other studies of sexual health training that included Canadian medical schools have assessed topic "coverage", which is based on the percentage of programs that taught a topic but does not necessarily reflect the degree or depth of emphasis. In their survey of Deans of medical education in U.S. and Canadian medical schools, Dunn and Alarie (1997) gathered information on a number of aspects of student sexual health training including the coverage given to 11 sexual health topics. However, specific topic coverage results reported for the 14 Canadian university respondents were limited to two examples: the percentage of programs that did not address sex in illness and/or disability (31%) and the percentage that did not address homosexuality and bisexuality (15%). Solursh et al. (2003) also included Canadian medical schools in their study of human sexuality education in North American medical schools but specific topic coverage for Canada was not reported. Similarly, a U.S./Canada study of LGBT and transgender- related topics addressed in undergraduate medical education reported coverage of 16 topics but also without specific reference to findings for the Canadian sub-sample (Obedin-Maliver et al., 2011).
The present study
The goal of the present study was to document the current status of topic emphasis and teaching methods used in sexual health training in all Canadian medical school programs in family medicine (FM) residency, obstetrics and gynaecology (OBG) residency and undergraduate medicine (UGM) (51 programs in total; 17 for each discipline). The current study is a partial replication of a comparable 1996 study (Barrett & McKay, 1998) and enables comparisons of the emphasis placed on the same sexual health topics in 1996 and 2011. …