Experts discuss the influence of sexual health education in medical school

In this video, Mayo Clinic Urology investigators Niki Parikh, MD, MBA, MSBA, Tobias S. Köhler, MD, MPH, and Matthew J. Ziegelmann, MD, highlight the background and findings from the study, “Perceived influence of medical school sexual health education on specialty selection in young urologists specializing in sexual dysfunction.”

Video Transcript:

Could you describe the background for this study?

Parikh: Sexual health is a very important component of everyone's overall quality of life. It not only influences the physical aspects of health, but the emotional and mental aspects as well. Sexual dysfunction is something important for all urologists to feel comfortable with and to feel comfortable addressing. We wanted to look at the sexual health curriculum exposure that trainees of various levels, including residents, fellows, and even early faculty staff had in medical school and assess the response that they had to that, as well as their response to mentorship throughout their life and whether that impacted their decision to pursue urology or further subspecialty training.

Köhler: Informally amongst the faculty in the men's health team here in Rochester, the staff asked one another, what kind of sexual health training they had received. It was really, really different. I personally had undergone a week of SAR, which is sexual attitude readjustment. They lock you and your classmates in the lecture hall for a week, and they show you everything that you can possibly think of. Then there's some medical schools that don't do anything. We were very curious as to how discrepant modern times are, and how that influences career choice and comfort levels of going into things. Obviously, urologists have to know about sexual health, but [for] primary care doctors [and] internal medicine doctors, [it's] very important not only for quality of life, but also sometimes the sexual health concerns could be predictors of cardiac disease, depression, etc.

Ziegelmann: Dr. Kohler and I are both involved in the medical school here at Mayo. We were looking at this too, as an opportunity to understand how we can get people even more excited about a field we know is awesome. Urology is such a great field, but how do we get people excited about urology and sexual health? And does it make a difference? If we are if we have this captive audience in medical school, does it make a difference if we engage in them. We learned a lot through this study, but that was the impetus. How can we how can we expose medical students early? What's the influence of exposing medical students to having a more fruitful career, and that extends beyond urology; that goes into primary care and family medicine, etc, like Dr. Kohler mentioned.

What were some of the notable findings?

Parikh: Overall, we conducted a survey [and] had about 94 respondents, and only about half recalled a dedicated sexual health curriculum at all during medical school. That's in a group of trainees who are heavily focused on also pursuing sexual medicine and reconstruction future in their life. We noticed while topics like sexual health and anatomy and physiology, were often covered, education on topics such as body image, sexual self esteem, sexuality across lifespans were some things that were not very well covered. Only 25% of our respondents felt that sexual health curriculum provided an adequate fund of knowledge at all to address any of the sexual health concerns of patients. And only 14% felt that that exposure influenced their decision to pursue urology.

When looking specifically into mentorships, there were a lot of people who had mentors who specialized in sexual medicine in their residency. It was around 80%. When we're looking specifically at individuals who intended to pursue a fellowship in sexual dysfunction, the factors that really seemed to be important were having an attending mentor, a mentor with expertise in sexual dysfunction. Most of those people considered mentorship important or very important in their decision to pursue subspecialty training, whereas the medical school exposure to sexual health curriculum didn't seem to play a role at all, highlighting the importance of mentorship.

Ziegelmann: Even amongst urologists or urology trainees, fellows, and some early staff who presumably had a desire to go into a field like this, most of them didn't feel that their medical school experience prepared them to adequately address their patient's concerns. I think it's important, and I think it underscores the need for us to really think about how we revamp medical school education as it pertains to sexual health.

This transcription has been edited for clarity.