Peter Salovey President | Yale University
Peter Salovey President | Yale University
A group of medical and public health students at Yale School of Medicine (YSM) has partnered with faculty mentors to develop a clinical skills-based simulation session on caring for transgender and gender diverse patients. This initiative, which began in May 2022, will be incorporated into the curriculum for all MD students during their clinical year.
Bassel Shanab, an MD student at YSM, noted that students were graduating "feeling uncomfortable in their ability to provide care to transgender and nonbinary patients." Although there were lectures on hormone replacement therapy and gender dysphoria, Shanab said, "we lacked the in-person clinical instruction that would ensure students can confidently serve such a marginalized group of patients."
Ryan Bahar, another MD student involved in the initiative, added that transgender and gender diverse individuals face significant health disparities compared to their cisgender counterparts. He attributed this disparity partly to insufficient training of medical students.
To address this gap, a team led by MD-PhD student Kyle Gavulic developed a curriculum focused on gender-affirming care. The team collaborated with Assistant Professor of Pediatrics Meredithe McNamara and MD student Christine Lepore. Together they created a proposal for a unique curriculum derived from two validated curricula on clinical skills in caring for transgender and gender diverse patients.
The curriculum was piloted in January 2023 with HAVEN Free Clinic. Thirteen medical, nursing, and PA student volunteers were trained using this new approach. The pilot demonstrated the effectiveness of the curriculum.
Following its success, it was decided that all MD and MD-PhD clerkship students would participate in this training during their orientation before each clerkship rotation. The first batch of 40 MD students underwent training in March 2024 with positive feedback.
Simulated participants (SPs), recruited from the local transgender and gender diverse community, played an essential role in the training. Jillian Celentano, an SP and advocate for the trans community, was instrumental in recruiting volunteers for the pilot.
Barbara Hildebrand, assistant director of the Simulated Participant Program, led the recruitment effort to hire enough SPs to train all medical students. The initiative resulted in six new SPs joining the program.
Reflecting on the initiative's impact, John Encandela, executive director of evaluation & assessment at YSM's Center for Medical Education, praised Gavulic and his team for their dedication. He credited them with identifying a gap in the curriculum and working tirelessly to fill it.
Gavulic said that this initiative has not only advanced YSM's undergraduate medical education on trans health care but also promises to equip future graduates with the skills needed to provide quality care to transgender and gender diverse patients.
Echoing these sentiments, McNamara emphasized that emerging physicians must be equipped with clinical skills to provide welcoming, comprehensive care to gender diverse people. She also highlighted the role of physicians in dispelling myths and protecting marginalized people amid a climate of misinformation regarding gender-affirming care.