Morrison Shane D, Dy Geolani W, Chong H Jonathan, Holt Sarah K, Vedder Nicholas B, Sorensen Mathew D, Joyner Byron D, Friedrich Jeffrey B
J Grad Med Educ. 2017 Apr;9(2):178-183. doi: 10.4300/JGME-D-16-00417.1.
With increasing public awareness of and greater coverage for gender-confirming surgery by insurers, more transgender patients are likely to seek surgical transition. The degree to which plastic surgery and urology trainees are prepared to treat transgender patients is unknown.
We assessed the number of hours dedicated to transgender-oriented education in plastic surgery and urology residencies, and the impact of program director (PD) attitudes on provision of such training.
PDs of all Accreditation Council for Graduate Medical Education-accredited plastic surgery (91) and urology (128) programs were invited to participate. Surveys were completed between November 2015 and March 2016; responses were collected and analyzed.
In total, 154 PDs (70%) responded, and 145 (66%) completed the survey, reporting a yearly median of 1 didactic hour and 2 clinical hours of transgender content. Eighteen percent (13 of 71) of plastic surgery and 42% (31 of 74) of urology programs offered no didactic education, and 34% (24 of 71) and 30% (22 of 74) provided no clinical exposure, respectively. PDs of programs located in the southern United States were more likely to rate transgender education as unimportant or neutral (23 of 37 [62%] versus 39 of 105 [37%]; = .017). PDs who rated transgender education as important provided more hours of didactic content (median, 1 versus 0.75 hours; = .001) and clinical content (median, 5 versus 0 hours; < .001).
A substantial proportion of plastic surgery and urology residencies provide no education on transgender health topics, and those that do, provide variable content. PD attitudes toward transgender-specific education appear to influence provision of training.
随着公众对性别确认手术的认识不断提高,以及保险公司对该手术的覆盖范围扩大,越来越多的跨性别患者可能会寻求手术转变。整形手术和泌尿外科住院医师准备好治疗跨性别患者的程度尚不清楚。
我们评估了整形手术和泌尿外科住院医师培训中用于跨性别相关教育的时长,以及项目主任(PD)的态度对提供此类培训的影响。
邀请了所有经研究生医学教育认证委员会认证的整形手术项目(91个)和泌尿外科项目(128个)的项目主任参与。调查于2015年11月至2016年3月期间完成;收集并分析了回复。
共有154名项目主任(70%)回复,145名(66%)完成了调查,报告每年关于跨性别内容的理论教学时长中位数为1小时,临床教学时长中位数为2小时。18%(71个项目中的13个)的整形手术项目和42%(74个项目中的31个)的泌尿外科项目未提供理论教学,分别有34%(71个项目中的24个)和30%(74个项目中的22个)未提供临床实习机会。位于美国南部的项目主任更有可能将跨性别教育评为不重要或中立(37个项目中的23个[62%],而105个项目中的39个[37%];P = 0.017)。将跨性别教育评为重要的项目主任提供了更多的理论教学内容时长(中位数,1小时对0.75小时;P = 0.001)和临床教学内容时长(中位数,5小时对0小时;P < 0.001)。
相当一部分整形手术和泌尿外科住院医师培训项目未提供跨性别健康主题的教育,而提供教育的项目内容也各不相同。项目主任对跨性别特定教育的态度似乎会影响培训的提供。