State of educational modalities employed in gender-affirming surgery amongst surgical residencies

Abstract

ObjectiveTo characterize the current state of educational modalities employed within surgical training programs in the field of gender-affirming surgery, summarize the modalities utilized, and propose recommendations for installation and improvement of surgical education on gender-affirming surgery.BackgroundThe current state of education must first be evaluated to better understand methods attempted, present voids and gaps, and resident attitude towards plans for improvement in surgical education in this field to address the rising demand for gender-affirming surgery and enable surgical residents involved in care of GAS across various subspecialties to provide sensitive, informed, and educated care.MethodsA scoping review was conducted. Data extraction included title, research question, data collection technique, sample size, sample characteristic, teaching modalities utilized, relevance, inclusion and exclusion criteria, and conclusion.ResultsThe study includes ten qualifying reports. 7 studies included data from residents of urology, obstetrics and gynecology, plastics, ENT, and oral and maxillofacial surgery residents. The remaining three studies reported results from program directors of urology, obstetrics and gynecology, plastics, and surgical dermatology programs. Reports of didactic educational programs amongst the described studies were unclear and inexplicit. There is limited structured exposure to the care of transgender people. Simulation-based experiences structured on gender-affirming surgery curricula can significantly improve surgical trainee understanding and knowledge.ConclusionRobust curricula involving didactic, clinical, and competency-based evaluation models are recommended to be designed and implement in surgical training programs seeking to care for GAS patients. Department and residency cultural competence didactics and clinical measures may be established to streamline subjects surrounding TGNC patient care. Additional efforts to establish dedicated LGBT and TGNC clinics, as well as an increased effort towards interdepartmental collaboration and exposure could enhance resident education.