LGBT Trainee and Health Professional Perspectives on Academic Careers—Facilitators and Challenges

Sánchez, Nelson F.; Rankin, Susan; Callahan, Edward J.; Ng, Henry; Holaday, Louisa W.; McIntosh, Kadian; Poll-Hunter, Norma; Sánchez, John Paul

doi:10.1089/lgbt.2015.0024

Cited by 99 publications

(109 citation statements)

References 48 publications

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“…Self-reported comfort and competence were greater among sexual minority medical students compared to their heterosexual peers, which may be partially attributable to the high rates of involvement in SGM professional work reported by SGM medical trainees and providers [14] and to the impact of personal experience with SGM health issues. Additionally, male-identified respondents reported greater competence and satisfaction with curricular preparation than female-identified respondents.…”

Section: Discussionmentioning

confidence: 99%

Sexual and gender minority health in medical curricula in new England: a pilot study of medical student comfort, competence and perception of curricula

Zelin

Hastings

Beaulieu‐Jones

et al. 2018

Medical Education Online

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Background: Sexual and gender minority (SGM) individuals experience high rates of harassment and discrimination when seeking healthcare, which contributes to substantial healthcare disparities. Improving physician training about gender identity, sexual orientation, and the healthcare needs of SGM patients has been identified as a critical strategy for mitigating these disparities. In 2014, the Association of American Medical Colleges (AAMC) published medical education competencies to guide undergraduate medical education on SGM topics.Objective: Conduct pilot study to investigate medical student comfort and competence about SGM health competencies outlined by the AAMC and evaluate curricular coverage of SGM topics.Design: Six-hundred and fifty-eight students at New England allopathic medical schools (response rate 21.2%) completed an anonymous, online survey evaluating self-reported comfort and competence regarding SGM health competencies, and coverage of SGM health in the medical curriculum.Results: 92.7% of students felt somewhat or very comfortable treating sexual minorities; 68.4% felt comfortable treating gender minorities. Most respondents felt not competent or somewhat not competent with medical treatment of gender minority patients (76.7%) and patients with a difference of sex development (81%). At seven schools, more than 50% of students indicated that the curriculum neither adequately covers SGM-specific topics nor adequately prepares students to serve SGM patients.Conclusions: The prevalence of self-reported comfort is greater than that of self-reported competence serving SGM patients in a convenience sample of New England allopathic medical students. The majority of participants reported insufficient curricular preparation to achieve the competencies necessary to care for SGM patients. This multi-institution pilot study provides preliminary evidence that further curriculum development may be needed to enable medical students to achieve core competencies in SGM health, as defined by AAMC. Further mixed methods research is necessary to substantiate and expand upon the findings of this pilot study. This pilot study also demonstrates the importance of creating specific evaluation tools to assess medical student achievement of competencies established by the AAMC.

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Section: Discussionmentioning

confidence: 99%

Sexual and gender minority health in medical curricula in new England: a pilot study of medical student comfort, competence and perception of curricula

Zelin

Hastings

Beaulieu‐Jones

et al. 2018

Medical Education Online

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“…This plays a major role in students concealing their identity or sexual orientation in the work place. Some students have even been deterred from participating in professional activities related to LGBT health issues, as they were poorly recognized, and that visibility might be associated with professional risks [18]. …”

Section: Introductionmentioning

confidence: 99%

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Nama

MacPherson

Sampson

et al. 2017

Medical Education Online

108

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Background: Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. Objective: The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Design: Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. Results: Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p < 0.001) or anti-LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). Conclusion: Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients.

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“…These factors, in identical order, were also ranked the most frequently as strong influences on specialty choice by the *14,000 graduating medical students who completed the 2015 AAMC Medical School Graduation Questionnaire. 17 Given the reported importance of SGM mentors to the professional development of SGM in healthcare 23 and the consistency with which role models are identified as strong influences on specialty choice among medical students, it is surprising that exposure to SGM faculty as an SGM medical student did not predict specialty choice, operationalized as specialty prestige, in this study. In part, this finding may reflect the importance of the quality of exposure or interaction with SGM faculty, as opposed to the frequency of exposure to SGM faculty.…”

Section: Discussionmentioning

confidence: 81%

“…Furthermore, under-representation of SGM within prestigious specialties may be a self-perpetuating phenomenon, as SGM identify SGM mentors as critical facilitators of professional success. 23 Equitable representation of SGM across specialties has the potential to positively impact SGM-based health disparities in the general population, which include obesity, mental health, tobacco and other substance dependence, teenage pregnancy, asthma, infectious disease, and certain cancers. [24][25][26] Deficits in cultural competency among physicians and overt anti-SGM bias and discrimination contribute to the creation and maintenance of disparities.…”

Section: Discussionmentioning

confidence: 99%

“…34 In addition, SGM in medicine often assume leadership roles in promoting educational reform, research, and clinical programs to address the health needs of SGM, and so may catalyze even greater downstream improvement in the health of SGM populations. 23 Further research is needed on the factors contributing to perceptions of anti-SGM bias within specialties. Preliminary evidence suggests that perceptions of SGM inclusion may partially reflect extant professional environments.…”

Section: Discussionmentioning

confidence: 99%

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Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

Sitkin

Pachankis

2016

LGBT Health

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Purpose: Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Methods: Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. Results: The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P < 0.001). Medical school climate did not predict specialty prestige (P = 0.82). SGM were more likely than non-SGM to indicate that sexual and gender identity strongly influenced specialty choice (P < 0.01). SGM most frequently rated personality fit, specialty content, role models, and work-life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Conclusion: Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities experienced by SGM.

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LGBT Trainee and Health Professional Perspectives on Academic Careers—Facilitators and Challenges

Cited by 99 publications

References 48 publications

Sexual and gender minority health in medical curricula in new England: a pilot study of medical student comfort, competence and perception of curricula

Sexual and gender minority health in medical curricula in new England: a pilot study of medical student comfort, competence and perception of curricula

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

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