LGBTQ+ Training in United States Radiation Oncology Residency Programs

Abstract

<h3>Purpose/Objective(s)</h3> The LGBTQ community is an understudied and medically underserved population who experience increased cancer risk and worse cancer outcomes. Negative provider interactions, including discrimination and lack of knowledge regarding LGBTQ-specific health issues are cited by patients as barriers to care, including in radiation oncology (RO). Notably, little is known regarding LGBTQ knowledge and attitudes among RO residents (ROR) or LGBTQ-specific training in RO residency training programs. Thus, we sought to assess the extent of current LGBTQ-specific training in U.S. RO residency programs. <h3>Materials/Methods</h3> Two published surveys of LGBTQ-education in residency were adapted to RO. The first assessed LGBTQ education from the perspective of program directors (PD) and associate PDs (APD), while the second survey was to RORs. The surveys were sent to all ACGME-accredited U.S. RO residency PD, APD, and program coordinators (PC), with the ROR survey being disseminated by the respective PCs. Each survey consisted of subsections of attitudes and knowledge in the care of LGBTQ patients, RO program characteristics, program inclusion of LGBTQ-specific education, and individual demographics. <h3>Results</h3> There were 69 responses (29 PD, APD and 40 ROR). The majority of respondents (PD, APD/ROR) identified as white (79%/58%), non-Hispanic (76%/72%), male (55%/55%), and heterosexual (86%/78%). The majority of PD, APDs did not receive LGBTQ education in medical school (60%) or residency training (96%), while the majority of residents (68%) did receive LGBTQ training in medical school; yet, both groups felt this training was insufficient to care for LGBTQ patients during residency (76%/68%). Overall, respondents felt comfortable treating LGB (90%/85%) and T (79%/62.5%) patients. However, the majority did not feel confident in their knowledge for LGB (52%/62.5%) or T (79%/85%) health needs. The majority of respondents' programs have never had a didactic session on LGBTQ health (78%/80%) resulting in 61%/61% of respondents feeling their program inadequately prepares residents to work confidently with LGBTQ patients. However, the majority felt their program is receptive to incorporating LGBTQ health content into their curriculum (75%/75%) and expressed a personal interest in such education (97%/80%). Additional data will be available by time of conference. <h3>Conclusion</h3> We found an increase of LGTBQ education in medical schools between PD, APD and ROR, suggestive of a recent improvement in LGBTQ content; yet most residency programs still lacked any LGBTQ-specific education. While the majority felt comfortable treating LGBTQ patients, they simultaneously lacked confidence in knowledge regarding LGBTQ health needs; yet, possessed desire for additional education and belief that such trainings should require. Conclusion is that residencies need to do a better job incorporating LGBTQ health content into their curricula, which is supported by interest from ROR and program leadership.