Practice Impact of a Dedicated LGBTQ+ Clinical Exposure During Residency

PRiMER. 2023 Jul 21:7:24. doi: 10.22454/PRiMER.2023.329607. eCollection 2023.

Abstract

Background and objectives: An increased focus on lesbian, gay, bisexual, transgender, queer (LGBTQ+) care in graduate medical education is needed to address health disparities in this patient population. This study assessed practice confidence and practice intentions of residents who rotated through an LGBTQ+ clinic during their residency.

Methods: Residents completed three to eight half-day sessions in a dedicated LGBTQ+ clinic focusing on primary care, pre-exposure prophylaxis (PrEP), and gender-affirming care from 2019 to 2022. Prior to this clinical experience, they were provided background reading materials, care guidelines, and clinical cases. Residents were electronically surveyed at two time points after completing this clinical experience to retrospectively assess their pre-and postcurricular confidence.

Results: Seventeen out of 18 (94%) residents who completed the curricular experience responded to the initial survey, which showed statistically significant differences between reported pre- and postcurricular confidence in providing primary care, PrEP, and gender affirmation care. Eight-eight percent of residents reported that they planned to or have already incorporated this care into their practice. In a follow-up survey 1 year later, 15 out of 18 (83%) responded, reporting consistent skills confidence. Seventy-one percent of participants reported currently providing LGBTQ+ care. We noted no statistical difference between the initial postconfidence survey and the follow-up survey.

Conclusion: This study demonstrated positive associations between a focused curricular experience in LGBTQ+ care and both confidence providing LGBTQ+ care and planned and actual postgraduation practice patterns.