Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directors

Abstract Background 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 specialtie...

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Main Authors: Andrew M. Pregnall, Joshua A. Pesantes, Gennady Vulakh, Youvin Chung, Setareh Gooshvar, C. Jessica Dine
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Education
Subjects:
Online Access:https://doi.org/10.1186/s12909-025-07551-7
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author Andrew M. Pregnall
Joshua A. Pesantes
Gennady Vulakh
Youvin Chung
Setareh Gooshvar
C. Jessica Dine
author_facet Andrew M. Pregnall
Joshua A. Pesantes
Gennady Vulakh
Youvin Chung
Setareh Gooshvar
C. Jessica Dine
author_sort Andrew M. Pregnall
collection DOAJ
description Abstract Background 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. Methods A cross-sectional, internet-based survey study of programs participating in the 2023–2024 Electronic Residency Application System, performed from September 2023-August 2024. Results 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%). Conclusions Multiple programs provide no didactic or clinical exposure to LGBTQ-related health topics, which does not align with the goals outlined by national organizations.
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spelling doaj-art-bd1d72f6451e4e3f8d07edcec3abbccf2025-08-20T03:38:14ZengBMCBMC Medical Education1472-69202025-07-0125111010.1186/s12909-025-07551-7Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directorsAndrew M. Pregnall0Joshua A. Pesantes1Gennady Vulakh2Youvin Chung3Setareh Gooshvar4C. Jessica Dine5Perelman School of Medicine, University of PennsylvaniaPerelman School of Medicine, University of PennsylvaniaPerelman School of Medicine, University of PennsylvaniaPerelman School of Medicine, University of PennsylvaniaPerelman School of Medicine, University of PennsylvaniaPerelman School of Medicine, University of PennsylvaniaAbstract Background 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. Methods A cross-sectional, internet-based survey study of programs participating in the 2023–2024 Electronic Residency Application System, performed from September 2023-August 2024. Results 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%). Conclusions Multiple programs provide no didactic or clinical exposure to LGBTQ-related health topics, which does not align with the goals outlined by national organizations.https://doi.org/10.1186/s12909-025-07551-7Graduate medical educationLGBTQSexual and gender minoritiesTransgenderResidencyACGME
spellingShingle Andrew M. Pregnall
Joshua A. Pesantes
Gennady Vulakh
Youvin Chung
Setareh Gooshvar
C. Jessica Dine
Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directors
BMC Medical Education
Graduate medical education
LGBTQ
Sexual and gender minorities
Transgender
Residency
ACGME
title Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directors
title_full Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directors
title_fullStr Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directors
title_full_unstemmed Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directors
title_short Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directors
title_sort evaluating the inclusion of lesbian gay bisexual transgender and queer related content in graduate medical education a national survey of program directors
topic Graduate medical education
LGBTQ
Sexual and gender minorities
Transgender
Residency
ACGME
url https://doi.org/10.1186/s12909-025-07551-7
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