LGBTQ+ Health Content in US Residency Curricula: A Scoping Review

Abstract

Background The care of lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) patients is heavily influenced by clinician training, but the landscape of LGBTQ+ health teaching in graduate medical education is poorly understood. Objective To describe the current state of LGBTQ+ health teaching across specialties within graduate medical education in the United States. Methods In February 2024, the authors performed a scoping review of the literature across 6 databases. Two authors extracted and synthesized data on the amount, scope, and modality of LGBTQ+ didactic and clinical teaching across residency programs, as well as educational interventions designed for resident learners. Results Fifty-two articles met inclusion criteria. In the past decade, the number of specialties with data on LGBTQ+ health teaching in residency increased from 4 to 12, encompassing both medical and surgical fields. Curricular hours and topics covered were highly variable even within specialties, but there were common educational gaps in transgender health and clinical exposure. Program director attitudes, region of training, and presence of LGBTQ+ identifying faculty were frequently linked to curricular inclusion of LGBTQ+ health. Surgical specialties appeared to lag medical specialties in amount and breadth of teaching, but had a stronger focus on gender-affirming surgical care. Educational interventions analyzed were highly diverse and trended toward inclusion of actual or simulated patient care alongside didactic teaching. Conclusions While attention to LGBTQ+ health in graduate medical education is increasing, critical gaps remain in the amount, scope, and delivery of LGBTQ+ health content across and within specialties.

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