International Journal of STD & AIDS > Volume 20, Number 5 > Pp. 324-329

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Original research articles

How do UK medical graduates rate their knowledge and skills in sexual health and HIV medicine? A national survey

C Estcourt MD FRCP ^*  , N Theobald MA MSc , D Evans MBBS MHPE , N Lomax MBBS MRCP , A Copas PhD ^**, L David FRCP , A Edwards MA FRCP , M Fisher MBBS FRCP  on behalf of the British Association for Sexual Health and HIV Undergraduate Working Group

^* Institute of Cell & Molecular Science, Queen Mary's School of Medicine and Dentistry, University of London, London E1 2AT; Ambrose King Centre, Barts and the London NHS Trust, London E1 1BB; Chelsea & Westminster Hospital, London SW10 9NH; Centre for Medical Education, Institute of Health Sciences Education, Barts and the London, Queen Mary's School of Medicine and Dentistry, University of London, London E1 2AD; ^** Centre for Sexual Health & HIV Research, University College London, London WC1E 6AU; Department of GU Medicine, George Eliot Hospital, Nuneaton, Warwickshire CV10 7DJ; Oxford Department of Genitourinary Medicine, Churchill Hospital, Oxford OX3 7LJ; Brighton and Sussex University Hospitals, Brighton BN2 5BE, UK

Correspondence to: Dr C Estcourt, Barts Sexual Health Centre, St Bartholomew's Hospital, London EC1A 7BE, UK Email: c.s.estcourt{at}qmul.ac.uk

The objectives of this study are to determine self-assessed knowledge and skills in sexual health and HIV medicine in preregistration house officers and to explore undergraduate experiences of teaching and assessment in these subjects prior to the launch of National Core Learning Outcomes in Sexual and Reproductive Health and HIV. The study was designed as a postal questionnaire survey. The participants were all UK medical graduates of August 2004. The response rate 1737/4746 (36%). The main outcome measures were Doctors’ views on their preparedness to manage patients with sexual health and HIV-related problems. Since graduation, 90% of respondents had seen at least one patient with a sexually transmitted infection or HIV-related issue. Seventy-six percent felt confident to take a sexual history. In all, 63% and 53% felt competent in male and female genital examination, respectively. Forty-three percent felt they could conduct an appropriate HIV pretest discussion and 59% felt they could recognize clinical indicators suggestive of HIV. Seventy-eight percent had been formally assessed in sexual health and 55% in HIV medicine. Increased confidence in sexual history taking, HIV pretest discussion and recognition of HIV indicators was associated with a longer duration of teaching and formal examination. In conclusion, although the proportion of recent graduates confident in sexual history taking is encouraging, their lack of skill in discussing HIV testing, risk assessment and recognition of possible HIV presentations must be addressed. Integration of National Core Learning Outcomes into all undergraduate curricula is a key step in reducing inconsistencies in undergraduate training.

Key Words: sexual health • HIV • undergraduate medical education

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