136 - First-year resident physician experiences in LGBTQ+ health education and preparedness to provide care for patients

Publication Number: 4133.136

Tess Jewell, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Laura Hanks, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States

Background: LGBTQ+ patients, especially those who identify as gender diverse, face discrimination and disparities in healthcare settings. Recent legislation impacts access of gender-affirming care to patients, and may impact resident education opportunities. Physician education is an important intervention to leverage to address current health disparities, and little is known about how the recent legislation changes may impact physician training.

Objective: We surveyed first-year resident physicians in the United States in specialties typically involved in gender-affirming care about (1) their experiences learning about care for LGBTQ+ patients, including those who identify as gender diverse, (2) their preparedness to engage in aspects of care for LGBTQ+ patients at the end of medical school, and (3) the degree to which gender-affirming care state policy and education opportunities impacted their rank order list for the residency match.

Design/Methods: All United States residency programs in obstetrics and gynecology, urology, plastic surgery, family medicine, internal medicine, and pediatrics were asked to share our survey with first-year residents in their program. Most questions utilized a five-point Likert scale for responses. Data were analyzed using descriptive statistics and Mann-Whitney U test. Statistical significance was considered at alpha = 0.05.

Results: We received 93 eligible survey responses, 27 in surgical specialties and 66 in non-surgical specialties. Prior education about healthcare for gender diverse patients was variable; 50.5% reported that their medical school offered pre-clinical coursework in this area, and 22.6% reported that their medical school offered a focused clinical elective. There was a statistically significant difference (p=0.008) between the degree to which opportunities to learn about gender-affirming care at a residency program impacted respondents' rank order lists for the residency match, comparing those in surgical and non-surgical specialties, with those in surgical specialties noting a greater degree of impact (average of 3.19 compared to 2.35, out of 5).

Conclusion(s): Residency programs should ensure there are educational opportunities in LGBTQ+ health, including care for gender diverse patients, for all residents, as medical school education on this topic is variable. While further research with larger samples is needed, pediatric programs need to understand how state legislation on access to gender-affirming care may impact learning experiences for their residents, as this has implications for resident recruitment and well-rounded training.

Figure 1: Average respondent preparedness to engage in aspects of care for LGBTQ+ patients at the end of medical school
*n=92 due to one respondent not selecting an answer for that item

Figure 2: Sources that prepared respondents to care for LGBTQ+ patients


Figure 3: Impact of state legislation and learning opportunities related to gender-affirming care on residency rank order list
**denotes statistical significance to p<0.01