Pregnall Andrew M, Pesantes Joshua A, Vulakh Gennady, Chung Youvin, Gooshvar Setareh, Dine C Jessica
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Medicine, Division of Pulmonary and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
BMC Med Educ. 2025 Jul 1;25(1):907. doi: 10.1186/s12909-025-07551-7.
National organizations have identified incorporation of LGBTQ-health content into graduate medical education programs as key action items; however, there has been no systematic study of LGBTQ-health content in these programs using a unified survey instrument across all specialties. The primary objective of this study was therefore to systematically evaluate the quantity of LGBTQ-related didactic and clinical education in graduate medical education programs using a unified survey.
A cross-sectional, internet-based survey study of programs participating in the 2023-2024 Electronic Residency Application System, performed from September 2023-August 2024.
Of 4,512 programs, 1,048 programs responded (23.2%). The median and mean number of didactic hours per year dedicated to LGBTQ-related content was 2.0 (IQR, 1.0-5.0, range, 0.0-200.0) and 4.0 (SD 9.1), respectively. The median and mean number of clinical hours per year dedicated to LGBTQ-related content was 10.0 (IQR, 1.5-40.0, range, 0.0-2000.0) and 61.0 (SD 188.4), respectively. Multiple programs reported that residents received no exposure to LGBTQ-related health content in either didactic settings (15.8%; 95% CI, 13.5-18.5%) or clinical settings (19.4%, CI 16.1 - 23.0%). The most covered didactic topics were gender identity (43.6%), sexual orientation (41.6%), and barriers to care (32.0%). The most covered clinical topics were Pre-Exposure Prophylaxis/Post-Exposure Prophylaxis (77.0%) and facial masculinization/feminization surgery (68.4%). The most cited barriers to including LGBTQ-related health topics were the lack of faculty with requisite knowledge/expertise (56.1%, CI 52.3 - 59.9%) and the lack of time (48.3%, CI 44.5 - 52.1%).
Multiple programs provide no didactic or clinical exposure to LGBTQ-related health topics, which does not align with the goals outlined by national organizations.
国家组织已将将 LGBTQ 健康内容纳入研究生医学教育项目确定为关键行动项目；然而，尚未有使用统一调查工具对所有专业的这些项目中的 LGBTQ 健康内容进行系统研究。因此，本研究的主要目的是使用统一调查系统评估研究生医学教育项目中与 LGBTQ 相关的理论教学和临床教育的数量。
对参与 2023 - 2024 年电子住院医师申请系统的项目进行基于网络的横断面调查研究，于 2023 年 9 月至 2024 年 8 月进行。
在 4512 个项目中，有 1048 个项目做出回应（23.2%）。每年用于 LGBTQ 相关内容的理论教学小时数的中位数和平均数分别为 2.0（四分位间距，1.0 -
5.0，范围，0.0 - 200.0）和 4.0（标准差 9.1）。每年用于 LGBTQ 相关内容的临床小时数的中位数和平均数分别为 10.0（四分位间距，1.5 - 40.0，范围，0.0 - 2000.0）和 61.0（标准差 188.4）。多个项目报告称，住院医师在理论教学环境（15.8%；95%置信区间，13.5 - 18.5%）或临床环境（19.4%，置信区间 16.1 - 23.0%）中均未接触到 LGBTQ 相关的健康内容。涵盖最多的理论教学主题是性别认同（43.6%）、性取向（41.6%）和护理障碍（32.0%）。涵盖最多的临床主题是暴露前预防/暴露后预防（77.0%）和面部男性化/女性化手术（68.4%）。纳入 LGBTQ 相关健康主题最常被提及的障碍是缺乏具备必要知识/专业技能的教员（56.1%，置信区间 52.3 - 59.9%）和缺乏时间（48.3%，置信区间 44.5 - 52.1%）。
多个项目未提供与 LGBTQ 相关健康主题的理论教学或临床接触，这与国家组织概述的目标不一致。
