June 16, 2021

Journal Notes: A Look at LGBTQ+ Articles, Past and Present

In honor of Pride Month, the Journal of Graduate Medical Education (JGME) is highlighting both recent and past articles tackling issues around LGBTQ+ diversity, equity, and inclusion. These pieces cover the breadth and variety of work that JGME publishes, from original research and educational innovation, to perspectives arguing for change, to personal stories and essays.

Below is a sampling of some of those articles, beginning with our current issue and going back to 2017. We hope you will find something of interest and explore further as we assess how far we have come and, most importantly, how much work still needs to be done.

The LGBTQ Applicant-Resident Chat: LGBTQ-Focused Residency Recruitment as an Opportunity for Increasing Diversity, Representation, and Inclusivity in Medical Training
The most recent of our featured articles comes from the June 2021 issue’s New Ideas section, a collection of brief articles published every June describing innovative interventions in graduate medical education. It describes one residency program’s practice of allowing applicants to opt into a confidential, one-on-one, informational interview day ‘‘chat’’ with a current LGBTQ-identifying resident volunteer. The promising outcomes of this initiative show that such programs may not only be feasible, but that they also may help increase the diversity of health care professionals who identify as lesbian, gay, bisexual, transgender, and queer.

Experiences of Transgender and Nonbinary Physicians During Medical Residency Program Application
This brief report, one of only two such studies to date, examines the experiences and perceptions of transgender and non-binary (TNB) residency applicants during the Match process through a 2019 survey. Respondents shared their perceptions of how safe they felt disclosing their gender identity and how they perceived such disclosures during interviews might influence their ranking. The study also highlights recommendations provided by TNB residency applicants for adopting gender-affirming practices and instituting policies that value gender diversity.

To Be or Not to Be Gay: The Odyssey of Applying to Residency as a Gay International Medical Graduate
JGME’s On Teaching section features personal stories and creative essays from residents, fellows, and physicians from the world of graduate medical education. This piece follows one applicant’s search for a residency program that clearly valued diversity and where he and his husband would feel at home. He relates some of the more difficult and uncomfortable moments he endured, as well as those where he felt welcomed and respected on the road to finding the “perfect fit.”

Addressing a Gender Identity Crisis in Medicine 
‘‘What is your gender? Male or female?” This one question from a multiple-choice audience response questionnaire in an ACGME focus group prompted a group of residents to pen this piece published in the February 2018 issue, arguing for removing such binary demographic questions from all future clinical, educational, and research materials and replacing it with a two-step gender format. The authors share their personal experiences to illustrate the real ways in which abstract principles of LGBTQ inclusion play out in the everyday lives of physician learners.

Transgender-Related Education in Plastic Surgery and Urology Residency Programs
This study surveyed plastic surgery and urology residents in 2015-2016 to determine the level of transgender-oriented education currently provided in surgical education programs and how prepared those programs’ residents might be to treat patients seeking gender transition. While most respondents endorsed the need for such education, the results suggest a lack of such training among surgical residents. The study also found that a program director’s attitude toward transgender patient care was a predictor of resident exposure to transgender-focused education, possibly introducing bias into a resident’s education.

Are We Adequately Preparing Our Trainees to Care for Transgender Patients?
This letter to the editor from 2017 argues that the ACGME should incorporate transgender-specific milestones into all fields of medical education and training. Since the integration of transgender patient care topics into the resident education curriculum are currently not mandated, the authors believe that doing so would benefit the necessary collaboration among specialties in this field.

Meeting the Primary Care Needs of Transgender Patients Through Simulation
Another New Idea, this one also from 2017, describes one program’s attempt to overcome the lack of training and experience with the needs of transgender patients by developing a simulation experience for primary care residents. It shows how faculty members and standardized patient feedback helped residents identify learning needs, such as how to ask directly about transition, how to use appropriate terminology, how to admit lack of knowledge to a patient, and how to recognize the need to put aside preconceptions about a patient’s identity.

 

This list is sure to grow as more in the GME community commit to LGBTQ+ diversity and continue to bring their research and ideas forward. JGME looks forward to what’s to come. All articles are open access and available on the JGME website.

 

Guest blogger Kevin Gladish is an editorial associate on the staff of the Journal of Graduate Medical Education. He’s been at the ACGME since 2016, and is also a performer, writer, and storyteller.

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