A survey of 167 medical residents revealed several shortcomings in medical training in sexual history taking, with dissatisfaction regarding adequacy of training, lack of skills and knowledge, discomfort, biases, and practical barriers undermining comprehensive sexual history assessments.
Key Findings
Results
Medical residents expressed dissatisfaction with the adequacy of their training in sexual history taking.
Survey conducted among 167 medical residents at the largest medical school in Belgium.
Participants completed an online questionnaire addressing aspects of sexual history training, skills, knowledge, attitudes, and factors influencing sexual history taking.
The training curriculum was also formally analyzed alongside the survey data.
Dissatisfaction was described as 'prominent' in the findings regarding the adequacy of provided training.
Results
Lack of skills and knowledge was identified as a prominent barrier to effective sexual history taking among medical residents.
Skills and knowledge deficits were described as a 'prominent barrier' to effective sexual history taking.
The survey assessed multiple domains including skills, knowledge, attitudes, and influencing factors.
These deficits were identified at 'the onset of their clinical practice,' suggesting gaps persisting through medical training.
The curriculum analysis corroborated these shortcomings identified by residents themselves.
Results
Discomfort experienced by both physicians and patients emerged as a critical factor affecting the initiation and quality of sexual history discussions.
Discomfort was described as 'a critical factor affecting the initiation and quality of sexual history discussions.'
The discomfort was reported on both sides of the clinical encounter — among physicians and among their patients.
This factor was distinct from knowledge/skills barriers, indicating an attitudinal dimension to the problem.
The study situates this within a broader recognition that sexual health is 'a fundamental component of well-being.'
Results
Biases related to religion, ethnicity, age, and gender were identified as challenges influencing sexual history taking among medical residents.
Four specific bias categories were identified: religion, ethnicity, age, and gender.
These biases were framed as challenges in conducting 'comprehensive sexual history assessments.'
The identification of these biases suggests attitudinal shortcomings beyond simple knowledge deficits.
The findings point to the need for 'more inclusive' sexual history taking practices.
Results
Practical factors including time constraints and language barriers were identified as additional obstacles to comprehensive sexual history assessments.
Time constraints and language barriers were listed among the 'multitude of obstacles in comprehensive sexual history assessments.'
These practical factors were considered distinct from skills, knowledge, and attitudinal barriers.
The combination of practical, attitudinal, and knowledge barriers points to a multifaceted problem in sexual health care.
The study was conducted in Belgium, where language barriers may reflect the multilingual clinical environment.
Conclusions
The study identified opportunities for improved training and made recommendations including targeted interventions to improve students' skills, knowledge, and attitudes.
Recommendations included 'targeted interventions to improve skills, knowledge and attitude of the students.'
The study framed its findings as highlighting 'opportunities for improved training in sexual history taking in medical education.'
Both the survey results and the curriculum analysis informed these recommendations.
The goal stated was contributing to 'more inclusive and effective sexual history taking practices.'
What This Means
This research surveyed 167 medical residents in Belgium about their training and experiences with asking patients about their sexual health history. The study found that residents were dissatisfied with the training they received, felt they lacked the skills and knowledge needed to take a good sexual history, and experienced discomfort — as did their patients — when these conversations came up. The researchers also analyzed the actual training curriculum and found it fell short of preparing doctors for these discussions.
Beyond discomfort and knowledge gaps, the study found that biases related to patients' religion, ethnicity, age, and gender also got in the way of thorough sexual health conversations. Practical issues like limited appointment time and language differences between doctors and patients added further obstacles. Together, these findings paint a picture of a medical training system that does not adequately prepare future doctors to discuss sexual health in a comprehensive or inclusive way.
This research suggests that medical schools should consider adding targeted training to help students build skills, deepen knowledge, and develop more open and unbiased attitudes toward sexual health topics. Since sexual health is widely recognized as an important part of overall well-being, gaps in how doctors are trained to discuss it could have real consequences for patient care — particularly for patients from groups whose sexual health needs may be overlooked due to physician bias or discomfort.
Bogaert E, Roels R. (2025). Sexual health in patient care: shortcomings in medical training and experienced barriers in sexual history taking.. BMC medical education. https://doi.org/10.1186/s12909-025-06850-3