Purpose: Approximately 1.4 million adults identify as transgender in the United States. Transgender patients face societal, legal, and medical discrimination that can lead to health disparities. The objective of this study was to evaluate knowledge and perceptions of transgender health care across various levels of medical training and specialties. Methods: Between April 1, 2019 and May 1, 2019, an anonymous survey was distributed to residents and attendings, in both medical and surgical specialties, at a university-affiliated hospital. Participants were recruited into the study with survey distribution by email to residency program directors, residents, and residency-affiliated attendings. Results: There was a response rate of 29.5% (118/400). Across all respondents, 34.7%, 31.4%, and 39% knew where to refer transgender patients for hormone replacement, psychotherapy, or surgery, respectively. Only 37.9% of residents and 46.2% of attendings reported that they were confident of providing care for a transgender patient (p = 0.130). In addition, less than one-third of surgical respondents reported sufficient knowledge to describe transgender surgery. The most common reasons affecting comfort level when caring for transgender patients were lack of exposure (53.4%) and lack of formal education (47.6%), with other reasons being personal, moral, and religious reasons (11%, 8.5%, and 6.8%, respectively). Conclusion: Despite literature demonstrating the effectiveness of formal didactics and education in transgender health, there remain disparities in the knowledge and comfort of residents and attendings across all specialties. To deliver competent health care to transgender patients, efforts must focus on improving the availability of system-wide resources and educational opportunities for all specialties.

No abstract

No abstract

Background Surgical residency training has an extended tradition of long hours. Residency programs use a variety of call schedules to combat resident fatigue and sleep deprivation while maintaining adherence to duty hour restrictions. Nonetheless, there is a paucity of data regarding objective measurements of sleep during the different call schedules included in general surgery training. Objective The primary objective of this study was to compare the quantity of sleep in 24-hour time frames across all types of shifts worked by general surgery residents at our institution. The secondary objective was to measure activity level in total steps during various time frames. Methods This prospective observational study was performed between April 4 and August 26, 2018, with general surgery residents. Each resident was assigned a Fitbit Charge 2 to wear during all rotations, including general surgery and subspecialty services. Results Twenty-six out of 31 residents voluntarily participated in the study (84%). In-house call (IHC) had significantly less sleep in a 24-hour time frame than home call and night float (144 vs 283 vs 246 minutes, P < .001 and P < .028). IHC had significantly more steps than home call (11 245 vs 8756 steps, P = .039). The smallest number of steps was obtained when residents were not working (7904 steps). Conclusions Our data demonstrate that surgical residents on IHC have significantly less sleep compared to all other types of on-call time frames. Residents on IHC have the most steps across all time frames.