Specialty Choice among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

LGBT Health

Volumn 3, Issue 6, 2016, Pages 451-460

  Sitkin, Nicole A ^a   Pachankis, John E ^b  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b YALE UNIVERSITY   (United States)

Author keywords

Gender identity; health education training program; minority stress; sexual orientation; survey design or survey methodology

Indexed keywords

CLIMATE; CONTROLLED STUDY; EXPOSURE; FEMALE; GENDER IDENTITY; HEALTH DISPARITY; HUMAN; HUMAN EXPERIMENT; LEADERSHIP; MALE; MEDICAL EDUCATION; MEDICAL SCHOOL; MEDICAL STUDENT; MEDICINE; MINORITY HEALTH; MODEL; PHYSICIAN; SEXUAL ORIENTATION; STRESS; TEACHER; ADULT; CROSS-SECTIONAL STUDY; CULTURAL ANTHROPOLOGY; DECISION MAKING; ETHNOLOGY; INTERNET; MENTAL STRESS; PERCEPTION; PERSONALITY; PSYCHOLOGY; QUESTIONNAIRE; SELF REPORT; SEXUAL AND GENDER MINORITY; SEXUAL BEHAVIOR; SOCIAL HIERARCHY; SPECIALIZATION; WORK-LIFE BALANCE;

ADULT; CAREER CHOICE; CROSS-SECTIONAL STUDIES; CULTURE; FEMALE; GENDER IDENTITY; HIERARCHY, SOCIAL; HUMANS; INTERNET; MALE; PERSONALITY; PHYSICIANS; SCHOOLS, MEDICAL; SELF REPORT; SEXUAL AND GENDER MINORITIES; SEXUAL BEHAVIOR; SOCIAL PERCEPTION; SPECIALIZATION; STRESS, PSYCHOLOGICAL; SURVEYS AND QUESTIONNAIRES; WORK-LIFE BALANCE;

EID: 85002427123     PISSN: 23258292     EISSN: 23258306     Source Type: Journal    
DOI: 10.1089/lgbt.2016.0058     Document Type: Article

References (59)

1. Meyer IH: Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol Bull 2003;129:674-697.
2. Hatzenbuehler ML: How does sexual minority stigma "get under the skin"? A psychological mediation framework. Psychol Bull 2009;135:707-730.
3. Pachankis JE: The psychological implications of concealing a stigma: A cognitive-affective-behavioral model. Psychol Bull 2007;133:328-345.
4. Pachankis JE, Goldfried MR, Ramrattan ME: Extension of the rejection sensitivity construct to the interpersonal functioning of gay men. J Consult Clin Psychol 2008;76:306-317.
5. Przedworski JM, Dovidio JF, Hardeman RR, et al.: A comparison of the mental health and well-being of sexual minority and heterosexual first-year medical students: A report from the medical student CHANGE study. Acad Med 2015; 90:652-659.
6. Lapinski J, Sexton P: Still in the closet: The invisible minority in medical education. BMC Med Educ 2014;14:171.
7. Brogan DJ, Frank E, Elon L, et al.: Harassment of lesbians as medical students and physicians. JAMA 1999;282:1290-1292.
8. Eliason MJ, Dibble SL, Robertson PA: Lesbian, gay, bisexual, and transgender (LGBT) physicians' experiences in the workplace. J Homosex 2011;58:1355-1371.
9. Merchant RC, Jongco AM 3rd, Woodward L: Disclosure of sexual orientation by medical students and residency applicants. Acad Med 2005;80:786.
10. Lee KP, Kelz RR, Dube B, Morris JB: Attitude and perceptions of the other underrepresented minority in surgery. J Surg Educ 2014;71:e47-e52.
11. Oriel KA, Madlon-Kay DJ, Govaker D, Mersy DJ: Gay and lesbian physicians in training: Family practice program directors' attitudes and students' perceptions of bias. Fam Med 1996;28:720-725.
12. Peota C: Out: The climate has changed for gay and lesbian physicians. Minn Med 2013;96:10-13.
13. Tinmouth J, Hamwi G: The experience of gay and lesbian students in medical school. JAMA 1994;271:714-715.
14. Risdon C, Cook D, Willms D: Gay and lesbian physicians in training: A qualitative study. CMAJ 2000;162:331-334.
15. Smith DM, Mathews WC: Physicians' attitudes toward homosexuality and HIV: Survey of a California Medical Society-revisited (PATHH-II). J Homosex 2007;52:1-9.
16. United States Census Bureau: Census Bureau regions and divisions with state FIPS codes. 2015. Available at www2.census.gov/geo/docs/maps-data/maps/reg-div.txt Accessed June 18, 2015.
17. Associaton of American Medical Colleges: Medical School Graduation Questionnaire: 2015 all schools summary report. 2015. Available at www.aamc.org/download/440552/data/2015gqallschoolssummaryreport.pdf Accessed August 3, 2016.
18. The National Resident Matching Program: Results and Data: 2015 main residency Match®. April, 2015. Washington, DC: National Resident Matching Program, 2015. Available at www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015-final.pdf Accessed August 9, 2016.
19. Medical Group Management Association: MGMA physician compensation and production survey: 2013 report based on 2012 data. Englewood, CO: Medical Group Management Association, 2013. Available at www.mgma.com/industry-data/all-data-resources/survey-and-report-updates Accessed August 9, 2016.
20. Chen JY, Heller MT: How competitive is the match for ra-diology residency? Present view and historical perspective. J Am Coll Radiol 2014;11:501-506.
21. Beasley TM, Schumacker RE: Multiple regression approach to analyzing contingency tables: Post hoc and planned comparison procedures. J Experimental Educ 1995;64: 79-93.
22. Brogan DJ, O'Hanlan KA, Elon L, Frank E: Health and professional characteristics of lesbian and heterosexual women physicians. J Am Med Womens Assoc 2003;58:10-19.
23. Sánchez NF, Rankin S, Callahan E, et al.: LGBT trainee and health professional perspectives on academic careers-Facilitators and challenges. LGBT Health 2015;2:346-356.
24. Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities: The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington (DC): National Academies Press (US), 2011.
25. Quinn GP, Sanchez JA, Sutton SK, et al.: Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. CA Cancer J Clin 2015; 65:384-400.
26. Pinkerton KE, Harbaugh M, Han MK, et al.: Women and lung disease. Sex differences and global health disparities. Am J Respir Crit Care Med 2015;192:11-16.
27. One Colorado Education Fund: Invisible: The state of LGBT health in Colorado. 2011. Available at www.one-colorado.org/wp-content/uploads/2012/01/OneColorado- HealthSurveyResults.pdf Accessed August 3, 2016.
28. Eliason MJ, Schope R: Does "don't ask don't tell" apply to health care? Lesbian, gay, and bisexual people's disclosure to health care providers. J Gay Lesbian Med Assoc 2001;5: 125-134.
29. Lambda Legal: When health care isn't caring: Lambda legal's survey on discrimination against LGBT people and people living with HIV. New York: Lambda Legal, 2010. Available at www.lambdalegal.org/sites/default/files/publications/downloads/whcic-report-when-health-care-isnt-caring.pdf Accessed August 3, 2016.
30. Grant JM, Mottet LA, Tanis J, et al.: Injustice at every turn: A report of the national transgender discrimination survey. Washington, DC: National Center for Transgender Equality and National Gay and Lesbian Task Force, 2011. Available at www.thetaskforce.org/static-html/downloads/reports/reports/ntds-full.pdf Accessed August 3, 2016.
31. Klamen DL, Grossman LS, Kopacz DR: Medical student homophobia. J Homosex 1999;37:53-63.
32. Li CC, Matthews AK, Aranda F, et al.: Predictors and consequences of negative patient-provider interactions among a sample of African American sexual minority women. LGBT Health 2015;2:140-146.
33. Rankow EJ, Tessaro I: Cervical cancer risk and Papanico-laou screening in a sample of lesbian and bisexual women. J Fam Pract 1998;47:139-143.
34. Burke SE, Dovidio JF, Przedworski JM, et al.: Do contact and empathy mitigate bias against gay and lesbian people among heterosexual first-year medical students? A report from the medical student CHANGE study. Acad Med 2015;90:645-651.
35. Chaimowitz GA: Homophobia among psychiatric residents, family practice residents and psychiatric faculty. Can J Psychiatry 1991;36:206-209.
36. Dunjic-Kostic B, Pantovic M, Vukovic V, et al.: Knowledge: A possible tool in shaping medical professionals' attitudes towards homosexuality. Psychiatria Danubina 2012;24:143-151.
37. Sanchez NF, Rabatin J, Sanchez JP, et al.: Medical students' ability to care for lesbian, gay, bisexual, and transgendered patients. Fam Med 2006;38:21-27.
38. Kopacz DR, Grossman LS, Klamen DL: Medical students and AIDS: Knowledge, attitudes and implications for education. Health Educ Res 1999;14:1-6.
39. Ficarrotto TJ, Grade M, Bliwise N, Irish T: Predictors of medical and nursing students' levels of HIV-AIDS knowledge and their resistance to working with AIDS patients. Acad Med 1990;65:470-471.
40. Kelley L, Chou CL, Dibble SL, Robertson PA: A critical intervention in lesbian, gay, bisexual, and transgender health: Knowledge and attitude outcomes among second-year medical students. Teach Learn Med 2008;20:248-253.
41. Grabovac I, Abramovic M, Komlenovic G, et al.: Attitudes to-wards and knowledge about homosexuality among medical students in Zagreb. Collegium antropologicum 2014;38:39-45.
42. Sherman MD, Kauth MR, Shipherd JC, Street Jr. RL: Provider beliefs and practices about assessing sexual orientation in two veterans health affairs hospitals. LGBT Health 2014;1:185-191.
43. Ramos MM, Tellez CM, Palley, et al.: Attitudes of physicians practicing in New Mexico toward gay men and lesbians in the profession. Acad Med 1998;73:436-438.
44. American Academy of Family Physicians: Family medicine residency curriculum guidelines. Available at www.aafp.org/medical-school-residency/program-directors/curriculum.html Accessed August 3, 2016.
45. Society of Teachers of Family Medicine: LGBT Health. Available at www.stfm.org/Groups/GroupPagesandDiscussion Forums/LGBTHealth Accessed August 3, 2016.
46. American Osteopathic Association: American Osteopathic Association Urges Physicians to Improve the Quality of Care for LGBT Patients, End Fear of Health Care Discrimination. 2015. Available at www.osteopathic.org/inside-aoa/news-and-publications/media-center/2015-news-releases/Pages/5-13-aoa-urges-physicians-to-improve-the-quality-of-care-for-lgbt-patients-end-fear-of-health-care-discrimination.aspx Accessed August 3, 2016.
47. The Joint Commission: Advancing effective communication, cultural competence, and patient-and family-centered care for the lesbian, gay, bisexual, and transgender (LGBT) community: A field guide. Oak Brook, IL, 2011. Available at www.jointcommission.org/assets/1/18/LGBTFieldGuide.pdf Accessed August 9, 2016.
48. Association of American Medical Colleges: Enhancing institutional diversity through inclusion of all sexual orientations and gender identities. May 2015. AAMC videos and resources. Washington, DC: Association of American Medical Colleges. Available at www.aamc.org/initiatives/diversity/431552/enhancinginstitutionaldiversitythroughinclusionofall sexualorien.html Accessed August 9, 2016.
49. American Medical Association: AMA policies on LGBT issues. Available at www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee/ama-policy-regarding-sexual-orientation.page? Accessed August 3, 2016.
50. Dhaliwal JS, Crane LA, Valley MA, Lowenstein SR: Student perspectives on the diversity climate at a U.S. medical school: The need for a broader definition of diversity. BMC Res Notes 2013;6:154.
51. Hatzenbuehler ML, Pachankis JE, Wolff J: Religious climate and health risk behaviors in sexual minority youths: A population-based study. Am J Public Health 2012; 102:657-663.
52. Pachankis JE, Hatzenbuehler ML, Starks TJ: The influence of structural stigma and rejection sensitivity on young sexual minority men's daily tobacco and alcohol use. Soc Sci Med 2014;103:67-75.
53. Coulter RW, Birkett M, Corliss HL, et al.: Associations between LGBTQ-affirmative school climate and adolescent drinking behaviors. Drug Alcohol Depend 2016;161:340-347.
54. Pachankis JE, Hatzenbuehler ML, Hickson F, et al.: Hidden from health: Structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey. AIDS 2015;29:1239-1246.
55. Hatzenbuehler ML, Keyes KM, Hamilton A, Hasin DS: State-level tobacco environments and sexual orientation disparities in tobacco use and dependence in the USA. Tob Control 2014;23:e127-e132.
56. Hatzenbuehler ML, O'Cleirigh C, Grasso C, et al.: Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment. Am J Public Health 2012;102:285-291.
57. Townsend MH, Wallick MM, Cambre KM: Support services for homosexual students at U.S. medical schools. Acad Med 1991;66:361-363.
58. Byne W: Forty years after the removal of homosexuality from the DSM: Well on the way but not there yet. LGBT Health 2014;1:67-69.
59. Schuster MA: On being gay in medicine. Acad Pediatr 2012; 12:75-78.