Care for Patients with Diverse Sexual Orientations, Gender Identities

Director(s): Alex Keuroghlian, Alberto Puig
Offered: Full-time every month
Location: MGH - Mass. General Hospital (3)
Open to Exclerks:
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,, for approval to enroll. This elective is a four-week multidisciplinary clinical-and-scholarly experience that trains students to provide high-quality, culturally responsive care for patients with diverse sexual orientations, gender identities, and sex development. Many of these patients identify as lesbian, gay, bisexual, transgender, queer, intersex or asexual (LGBTQIA+). Clinical exposure and education will focus on serving gender and sexual minority people across the lifespan, from infants to older adults. The elective includes partnerships and clinical experiences at Harvard Medical School hospitals and within community settings, including clinical experiences at Boston Children’s Hospital, Massachusetts General Hospital, Cambridge Health Alliance, Fenway Health Center, Boston Health Care for the Homeless, and other health care organizations in the Great Boston Area that serve LGBTQIA+ communities. Students will work with multidisciplinary teams in a variety of clinical settings and specialties, including but not limited to Adolescent Medicine, Endocrinology, Family Practice, Infectious Disease, OBGYN, Pediatrics, Psychiatry, Psychology, Primary Medical Care, and Plastic Surgery. They will be immersed in clinical practices committed to promoting health and resiliency for gender and sexual minority communities. The combination of clinical experiences will be tailored based on students’ interests. This rotation will emphasize both mentored and self-directed learning, with core educational material developed by faculty at Harvard Medical School and its affiliates, The Fenway Institute, and other national experts. Based on individual interests, students will have the opportunity to engage in a mentored scholarly endeavor related to gender and sexual minority health. This project may consist of an advocacy, quality improvement, medical education, original research, or public health project. A scholarly product is required at the end of the rotation and could be in the form of a poster, case report, literature review, viewpoint or perspective piece, original research report, oral presentation, or contribution to the course curriculum. Many students have successfully published their mentored scholarly project from the elective as a peer-reviewed article or parlayed this work into their Scholars in Medicine project. There is no call expectation during this elective.
Incorporation of Basic Science Content and Evidence-Based Medicine:
At the beginning of the elective, each medical student will receive an updated packet of foundational and current peer-reviewed articles in the area of gender and sexual minority health, to ground their clinical experience in relevant basic science and evidence-based practice.

Students will observe clinicians engaging in evidence-based medical care with the populations describe above. In addition, the medical student will engage in clinical practice themselves while being directly supervised by faculty attendings and fellows, most 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 report entitled, “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 primary learning goals adapted from the 30 competencies of the Physician Competency Reference Set (PCRS) that the AAMC contextualized to ensure that trainees acquire the knowledge, attitudes and skills needed to provide sensitive and affirming care for the aforementioned populations.

This senior elective is closely aligned with Harvard Medical School’s Sexual and Gender Minority Health Equity Initiative, to ensure integrated and longitudinal medical training to foster excellence caring for patients with diverse sexual orientations, gender identities, and sex development.
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.
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.
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.
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.