Future Doctors Score a “D” in Sexual Health Knowledge Because Sex Ed Barely Exists in Medical School

The state of sex education is poor for American adolescents—but you probably already knew that. However, what you may not have realized is that the state of sex education for US medical students isn’t all that great, either. This is both surprising and sad, given all of the important implications (good and bad) that sex can have for our health. 

There’s no universal standard for how sexuality should be taught in medical school, nor is there even a requirement that it be taught at all! Believe it or not, just half of US medical schools currently mandate that students receive formal instruction in the area of sexuality [1]. Clearly, there’s a lot of variability from school to school; however, the lack of standards and requirements necessarily means that students don’t spend much time learning about sex-related issues.

 A survey sent to the curriculum directors at all American medical schools that inquired about the number of hours spent on sexuality instruction revealed the following [2]: 

·     13.2% offered 2 hours or less

·     24.5% offered 3-5 hours

·     29.6% offered 6-10 hours

·     17.4% offered 11-19 hours

·     15.3% offered 20 or more hours

What these figures tell us is that just over two-thirds of future doctors are receiving less than 10 hours of sex education across their entire four years in medical school. In other words, they spend about 2.5 hours per year learning about the subject. That’s not a lot of time to learn everything they need to know about things like taking sexual histories from patients, STD testing and treatment, sexual dysfunctions and therapies, LGBTQ issues, contraception and safer sex, sexual violence and victimization, etc.

It should be no surprise to learn that medical students’ sexual health knowledge therefore tends to be pretty low. As evidence of this, one study that quizzed 178 medical students about sexual health using a 32-item measure found that the average student scored a 66%, the equivalent of a “D” grade [1]. Scores were actually lowest on the subset of items that assessed safety and prevention (students scored an average of 49% on this, or the equivalent of an “F”). 

This is consistent with a separate study of more than 2,000 US medical students, which revealed that only 41% felt that they received comprehensive training in discussing safe-sex matters with patients [3]. Moreover, only about half of students in this study (55%) reported that it would be highly relevant to provide patients with counseling on safe sex. 

All in all, what these findings tell us is that the people who really should know the most about sex—our doctors—aren’t learning what they need to in medical school. We need our doctors to be able to answer our sex questions, to be sensitive to patients with diverse sexual interests and identities, to provide safe-sex counseling, to order the correct tests, and to deliver the most effective treatments; however, to do all of this, we need our doctors to be trained extensively in sex and sexuality issues. 

To that end, we need to expand our calls for improved sex education from adolescents to encompass medical students because no one needs to know more about sex than the people we entrust to take care of our sexual health for our entire lives. 

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[1] Warner, C., Carlson, S., Crichlow, R., & Ross, M. W. (2018). Sexual Health Knowledge of US Medical Students: A National Survey. The Journal of Sexual Medicine15(8), 1093-1102.

[2] Solursh, D. S., Ernst, J. L., Lewis, R. W., Prisant, L. M., Mills, T. M., Solursh, L. P., ... & Salazar, W. H. (2003). The human sexuality education of physicians in North American medical schools. International Journal of Impotence Research15(S5), S41.

[3] Frank, E., Coughlin, S. S., & Elon, L. (2008). Sex-related knowledge, attitudes, and behaviors of US medical students.Obstetrics & Gynecology,112(2), 311-319.

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