Abstract
BACKGROUND: Gay and lesbian physicians in training face considerable challenges as they become professionalized. Qualitative research is necessary to understand the social and cultural factors that influence their medical training. In this study we explored the significance of gay or lesbian identity on the experiences of medical training using naturalistic methods of inquiry. METHODS: Semi-structured interviews, focus groups and an e-mail listserv were used to explore professional and personal issues of importance to 29 gay and lesbian medical students and residents in 4 Canadian cities. Data, time, method and investigator triangulation were used to identify and corroborate emerging themes. The domains explored included career choice, "coming out," becoming a doctor, the environment and career implications. RESULTS: Gay or lesbian medical students and residents experienced significant challenges. For all participants, sexual orientation had an effect on their decisions to enter and remain in medicine. Once in training, the safety of a variety of learning environments was of paramount importance, and it affected subsequent decisions about identity disclosure, residency and career path. Respondents' assessment of professional and personal risk was influenced by the presence of identifiable supports, curricula inclusive of gay and lesbian sexuality and health issues and effective policies censuring discrimination based on sexual orientation. The need for training programs to be proactive in acknowledging and supporting diversity was identified. INTERPRETATION: Considerable energy and emotion are spent by gay and lesbian medical students and residents navigating training programs, which may be, at best, indifferent and, at worst, hostile.
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Selected References
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- Chaimowitz G. A. Homophobia among psychiatric residents, family practice residents and psychiatric faculty. Can J Psychiatry. 1991 Apr;36(3):206–209. doi: 10.1177/070674379103600309. [DOI] [PubMed] [Google Scholar]
- Cook D. J., Griffith L. E., Cohen M., Guyatt G. H., O'Brien B. Discrimination and abuse experienced by general internists in Canada. J Gen Intern Med. 1995 Oct;10(10):565–572. doi: 10.1007/BF02640367. [DOI] [PubMed] [Google Scholar]
- Martin H. P. The coming-out process for homosexuals. Hosp Community Psychiatry. 1991 Feb;42(2):158–162. doi: 10.1176/ps.42.2.158. [DOI] [PubMed] [Google Scholar]
- Rose L. Homophobia among doctors. BMJ. 1994 Feb 26;308(6928):586–587. doi: 10.1136/bmj.308.6928.586. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tinmouth J., Hamwi G. The experience of gay and lesbian students in medical school. JAMA. 1994 Mar 2;271(9):714–715. doi: 10.1001/jama.271.9.714. [DOI] [PubMed] [Google Scholar]
- Townsend M. H., Wallick M. M., Cambre K. M. Follow-up survey of support services for lesbian, gay, and bisexual medical students. Acad Med. 1996 Sep;71(9):1012–1014. doi: 10.1097/00001888-199609000-00018. [DOI] [PubMed] [Google Scholar]
- Wallick M. M., Cambre K. M., Townsend M. H. How the topic of homosexuality is taught at U.S. medical schools. Acad Med. 1992 Sep;67(9):601–603. doi: 10.1097/00001888-199209000-00013. [DOI] [PubMed] [Google Scholar]
- vanIneveld C. H., Cook D. J., Kane S. L., King D. Discrimination and abuse in internal medicine residency. The Internal Medicine Program Directors of Canada. J Gen Intern Med. 1996 Jul;11(7):401–405. doi: 10.1007/BF02600186. [DOI] [PubMed] [Google Scholar]