How pharmacy education is evolving to meet the needs of LGBTQ + patients – University Affairs


Sexual minorities continue to face barriers to care, says a professor revising the curriculum at Dalhousie University.

After more than a decade abroad, Kyle Wilby recently moved to Canada for a big job: to lead a curriculum revamp at Dalhousie University’s College of Pharmacy. Dr. Wilby’s work focuses on how pharmacy can better serve the LGBTQ + population. Before arriving in Halifax, he developed a curriculum in New Zealand – one of the few places where Dr Wilby has said pharmacy education is evolving to better respond to LGBTQ + care.

While there has been a push in recent years to train nurses or physicians in inclusive care, “there is very little in the pharmacy field,” said Dr. Wilby. He sees this as a missed opportunity, as pharmacists are typically integrated into the communities they serve and therefore tend to be more accessible. But there has been some activity in the field, offering hormone therapy injections for transgender patients, for example, or rapid point-of-care HIV testing.

The LGBTQ + population continues to face barriers to care, including stigma, discrimination and past traumatic experiences in healthcare facilities, said Dr Wilby. For example, patients who are not “out” or who are uncomfortable discussing their sexuality with their doctor may have poorer health outcomes because their care needs may not be met. fully taken into account. Such obstacles have been widely documented in medical research, including the need for healthcare professionals to be more sensitive to them. Last April, researchers at the University of Toronto published a study arguing for standards in LGBTQ + medical education. (The school’s medical residency program made changes in this area in 2020, incorporating LGBTQ + health-specific courses into the curriculum and training).

Dr Wilby said pharmacy needs to be part of this conversation. “We can offer this primary care resource, where someone can come and discuss a problem before they have to go to a health center, which could be more triggering.” This is also one of the main reasons why pharmacy schools should foster links with local LGBTQ + organizations, so that more practicing pharmacists are aware of the services their patients might need.

Education is the starting point, especially since the regulations governing what pharmacists can do vary from province to province (unlike physicians). This means that pharmacy schools are where new standards can be set, explained Dr Wilby. Mainstreaming LGBTQ + health across the curriculum would be a step forward (rather than in an elective course or a single conference). “People who register for these [elective] the classes are probably more inclusive anyway, ”he said. “It is pharmacists who do not benefit from taking this elective course who need it. “

Rethinking Core Beliefs

A similar shift is happening at the University of Toronto’s School of Pharmacy, where Jamie Kellar agrees that integration is the goal. Dr Kellar is overseeing the overhaul of this school’s curriculum, which will include more course content on LGBTQ + health and closer partnerships with community-serving groups. She said her field has not been at the forefront on the issue compared to other health professions because of core beliefs about accessibility.

“There has been a common understanding that drug provision and education would be similar across the board no matter who you are doing it for, and it actually isn’t,” she said. declared. “When you provide medication training, you tailor it to the person and their experience with taking medication or how they view medication. “

There is also the physical space to consider. Dr Wilby said that while pharmacies may be easy to access, a lack of LGBTQ + signage or adequate privacy can hinder this.

“An obligation to do things well”

Dr Kellar also believes pharmacy schools play an important role in driving change, which includes standardizing skill requirements. “Our educational outcomes for Canadian pharmacists are the same across all of our schools,” she said. “So adding skills specific to different groups would ensure that all pharmacists entering the workforce are competent to provide care, in all kinds of fields.”

Most of the time, the training focuses on communicating with patients from all walks of life. While this is important, Dr Wilby said the curriculum needs to ensure that students understand the root cause of the problems their patients face. “It always comes down to the potential trigger for healthcare facilities and the need to look at inclusiveness as a whole,” Dr. Wilby said. “Sometimes students don’t necessarily know what they need to know. “

The pandemic has highlighted the discipline of pharmacy in an unprecedented way, especially the accessibility aspect. When people couldn’t come in to see their family doctor, Dr. Kellar pointed out, their pharmacist was always there to help. “It has been great from the point of view of the profession, but I also think that it comes with a requirement for us, as educators, to recognize the role that we can play, positively but also negatively”, she declared. “We have an obligation to do it right.”


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