Gay and lesbian physicians in training: a qualitative study

Background: Cay and lesbian physicians in training face considerable challe nges as they become professionalized. Qualitative research is necessary to understand the social and cultural factors that influence their medical tra ining. in this study we explored the significance of gay or lesbian identit y on the experiences of medical training using naturalistic methods of inqu iry. Methods: Semi-structured interviews, focus groups and an email listserv wer e 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 corrobora te emerging themes. The domains explored included career choice, "coming ou t," becoming a:doctor, the environment and career implications. Results: Cay or lesbian medical students and residents experienced signific ant challenges. For all participants, sexual orientation had an effect on t heir decisions to enter and remain in medicine. Once in training, the safet y of a variety of learning environments was pf paramount importance, and it affected subsequent decisions about identity disclosure, residency and car eer path. Respondents' assessment of professional and personal risk was inf luenced by the presence of identifiable supports, curricula inclusive of ga y 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 lesbia n medical students and residents navigating training programs, which may be , at best, indifferent and, at worst, hostile.