Sexual minority identity impacts career trajectory among medical students

The conversation surrounding equal rights for the LGBTQ+ community has recently been in the political spotlight in the U.S. But, despite advances in civil rights, this population continues to suffer from unique disparities among both patients and healthcare providers.

A study co-authored by Matthew Mansh, MD, corresponding author and a dermatologist with the University of Minnesota Medical School and M Health Fairview, published today on the JAMA Network, aimed to assess the distribution of sexual minorities by intended specialty among graduating medical students. The researchers' results show that not only are sexual minority people underrepresented within undergraduate medical training, but that there are disparities in which fields they intend to pursue after graduating.

"Sexual minorities face numerous health disparities, including poor access to knowledgeable providers and culturally-sensitive care," Mansh said. "Workforce diversity is essential to ensure a pipeline of physicians equipped through personal experiences and diverse learning environments to improve care for sexual minority people, but little is known about sexual orientation diversity in medical training."

The study analyzed de-identified, self-reported data between 2016 and 2019 from the Association of American Medical Colleges Graduate Questionnaire. They compiled the following key statistics:

• Only 5.7% of female medical students identified as sexual minority, compared to an estimated 9.4% of young females in the general population who identify as sexual minority.
• Sexual minority female medical students were less likely to intend to practice in primary care specialties and more likely to want to practice in surgical specialties as compared to their heterosexual female peers.
• Sexual minority male medical students were less likely to intend to practice in surgical specialties and more likely in primary care specialties as compared to their heterosexual male peers.

The researchers concluded that sexual minority people—specifically sexual minority females—are underrepresented in undergraduate medical training and also in the workforce pipeline towards certain specialties. But, overall, sexual minority diversity varied significantly between specialties.

Further research is needed to better understand the causes of these disparities, including the impact of specialty-specific training environments, such as perceived inclusivity and/or trainee mistreatment.

"Sexual orientation data collection should be standardized in all physician workforce surveys and sexual minority diversity should be considered in undergraduate and graduate medical training recruitment to promote a diverse physician workforce across all specialties," Mansh said.

Co-authors of this study are Westly S. Mori, MD, and Yi Gao, MD, of the U of M Medical School; Eleni Linos, MD, MPH, DrPH; Mitchell R. Lunn, MD, MAS; Juno Obedin-Maliver, MD, MPH, MAS, of the Stanford University School of Medicine; and Howa Yeung, MD, MSC, of the Emory University School of Medicine.