IND510M.7

Care for Patients w/Diverse Sexual Orientations&Gender Identitie

Director(s): Joseph Baker, Jeremi Carswell, Alex Keuroghlian
Offered: Full time for one month.
Location: CHMC - Children's Hosp Medical Center (7)
Open to Exclerks: No (HMS only)
Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Alex Keuroghlian, akeuroghlian@partners.org, for approval to enroll. This elective is a four-week multi-disciplinary clinical-and-scholarly experience that trains students to provide high-quality, patient-care to patients who are LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning), Gender Nonconforming, or Born with DSD (Differences of Sex Development). While there will be an emphasis on working with youth, clinical exposure and education on working with LGBTQ adults will also be included to expose students to common health issues related to LGBTQ status that arise across the lifespan. The elective will primarily be based at Boston Children�s Hospital, but will also include partnerships within the community, including clinical experiences at Fenway Health Center, Cambridge Health Alliance, and other hospitals engaged in LGBT healthcare. Students will have exposure to multidisciplinary teams and providers in different clinical settings as related to LGBTQ healthcare, including but not limited to Psychiatry, Adolescent / Young Adult Medicine, Pediatrics, Family Practice, Internal Medicine, and the Disorders of Sex Development (DSD) and the Gender Management Service (GeMS). They will have exposure to other members of the community that play an important role in promoting health and resiliency. Education and self-directed learning will be emphasized during this rotation with core educational material developed by the Fenway Health Institute and National LGBT Health Education Center and from the AAMC�s Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals who are LGBT, Gender Nonconforming, or Born with DSD. Students will have the opportunity to engage in a scholarly endeavor related to LGBTQD health based on their interest. The endeavor could consist of an advocacy, public health, research, QI or medical education project. A scholarly product is required at the end of the rotation and could be in the form of a poster, case report/publication, presentation, or contribution to the curriculum. There is no call expectation.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Incorporation of Basic Science Content and Evidence-Based Medicine:
The medical student will observe clinicians engaging in evidence-based medical practice with the individuals describe above. In addition, the medical student will engage in clinical practice themselves while being directly supervised by faculty attendings and fellows, many of whom have a strong background and/or expertise in evidence-based medical practice. The educational framework for this elective is based on recommendations of the AAMC�s Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals who are LGBT, Gender Nonconforming, or Born with DSD � A Resource for Medical Educators, with many of primary learning goals being adapted from the 30 competencies from the Physician Competency Reference Set (PCRS) that the AAMC contextualized to assure that trainees acquire the knowledge, attitudes and skills needed to provide sensitive and appropriate care to the aforementioned populations. Education and evidence-based practice will be emphasized during this rotation with core educational material including the following:
A � Utilizing a flipped classroom approach, the medical student will be asked to watch the following three online modules developed by the Fenway Health Institute and National LGBT Health Education Center and have a 1:1 follow-up discussion with an identified faculty clinician from Boston Children�s Hospital or the Fenway Health Institute: http://www.lgbthealtheducation.org/training/learning-modules/:
1.Achieving Health Equity for LGBT People
2.Improving Health Care for Transgender People
3.Caring for LGBTQ Youth in Clinical Settings
B- Selected chapters from The Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health. (2015). American College of Physicians. http://www.lgbthealtheducation.org/publications/top/:
Chapter 1: Providing Optimal Health Care for LGBT People: Changing the Clinical Environment and Educating Professionals
Chapter 5: Caring for LGBTQ Youth
Chapter 8: Principles for Taking an LGBTQ-Inclusive Health History and Conducting a Culturally Competent Physical Exam
Chapter 12: Sexual Health of LGBTQ People
Chapter 15: Self-Discovery: A Toolbox to Help Clinicians Community with Clarity, Curiosity, Creativity, and Compassion
Chapter 16: Gender Nonconfirmity and Gender Discordance in Childhood and Adolescence: Developmental Considerations and the Clinical Approach
C- Case-based discussions, using cases developed by the AAMC (i.e. Clinical Scenarios and Discussions Points for Experiential Learning) and the Gay Alliance SafeZone Program.
Grade Criteria:
Honors with Distinction:
Performance level exceeding expectations in all areas compared to most students at current level of education and training. Student consistently excels at clinical interventions demonstrating mastery of advanced concepts and skills.
Honors:
Performance level exceeding expectations in most areas for current level of education and training. Demonstration of significant acquisition of concepts and skills that support current practice at a house officer level.
Pass:
Performance level meeting expectations in all areas for current level of education and training. Student completes assignments and delivers care in a safe and reliable manner that demonstrates readiness for further learning.
Unsatisfactory:
Performance level that does not meet expectations for current level of training and education. Student does not complete assignments, does not demonstrate acquisition of knowledge or skills needed for further learning, evidence of unsafe clinical practice and need for remediation.