Overall fit is the factor cited most often by medical students in ranking residency programs, but diagnosing fit can be challenging and stressful for LGBTQ applicants, regardless of whether they are out. An internist and an emergency medicine physician offer tips for applying, interviewing and ranking to help you find the culture and the support you need.
First, decide whether you will be out. This will predetermine several other decisions. “I have no value judgment around that, other than to say it’s hard to be happy when you don't feel safe to be out,” said Carl Streed Jr., MD, MPH, an internist and assistant professor of medicine at Boston University School of Medicine and research lead for its Center for Transgender Medicine & Surgery.
“If you can’t be happy at your work, you’re not going to live up to your potential. Recognize that the choice to stay in the closet is a hard one.”
Read the signs—literally and figuratively. “I definitely looked at how the program represented themselves publicly,” said Hunter Pattison, MD, chief resident in the emergency medicine department at the University of California Davis Medical Center.
He still remembers spotting a poster in an elevator promoting UC Davis’ interest in LGBTQ patients. “Look not just at what the program is saying to you, but also what it’s saying to patients and the community. That will give you a sense of the community it’s trying to culture and whether its priorities line up with yours.”
Seek allies. “I made a point of pulling aside anybody who had a rainbow pin on them and asking them questions that I wasn’t able to ask higher-ups,” said Dr. Streed, noting that he latched onto any signal of a welcoming environment or anything else that gave him confidence in LGBTQ clinical care.
“Also, talk to residents and see how welcoming they are. Do they feel comfortable bringing their significant others to interviewing events? If so, that can indicate a welcoming environment.”
Dr. Pattison, who is also the AMA Resident and Fellow Section representative of the AMA Advisory Committee on LGBTQ Issues, agrees.
“Reaching out to people who have gone through the process helped me not feel alone,” he said. “It doesn’t have to be an interviewer. It could just be someone you meet in the hallway.”
Ask lots of questions. “This is a big move in both your personal life and your career,” Dr. Pattison said. “If there’s something you need to know about a program, don’t be afraid to ask about it.”
Dr. Streed, former chair of the AMA Advisory Committee on LGBTQ Issues, acknowledges the discomfort that comes with this.
“You can’t say, ‘I have a friend …’ Nobody buys that,” he said. “If you don’t feel comfortable asking your interviewers, find residents you can talk to.”
Don’t settle for a program that doesn't meet your needs. “This can be difficult for people depending on where they are in their careers and how open they are,” Dr. Pattison said, adding that he succeeded with the couples Match.
“Residency is really tough. It’s physically and emotionally taxing and draining. The last thing you want is to have a layer of concern that you can’t be open or you have to guard a part of yourself out of fear that you wont be accepted.”