Future doctors aren't learning much about the unique health needs of gays and lesbians, a survey of medical school deans suggests. On average, the schools devoted five hours in the entire curriculum to teaching content related to lesbian, gay, bisexual and transgender patients, according to the survey results appearing in Wednesday's Journal of the American Medical Association. A third of the schools had none during the years students work with patients. More than a quarter of the medical school deans said their school's coverage of 16 related topics was "poor" or "very poor." The topics included sex change surgery, mental health issues and HIV-AIDS. While nearly all medical schools taught students to ask patients if they "have sex with men, women or both" while obtaining a sexual history, the overall curriculum lacked deeper instruction to help "students carry that conversation as far as it needs to go," said lead author Juno Obedin-Maliver, MD, of the University of California, San Francisco. Without such education, doctors are left guessing and can make faulty assumptions, Obedin-Maliver said. For instance, lesbians need Pap tests, which screens for the sexually spread virus that causes most cervical cancer, as often as heterosexual women do. But some doctors assume they don't need them.