Collaborative Efforts Between Medical Faculty and Learners to Enhance the Institutional Climate for LGBTQ+ Trainees

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To the Editor: Trainees who identify as LGBTQ+ face unique challenges within the medical education pathway. In their qualitative analysis, Srifuengfung and colleagues describe LGBTQ+ medical students who expressed fear of retaliation, negative judgment, or being perceived as unprofessional if attending physicians were to discover their LGBTQ+ identity. The authors found that cultivating a respectful environment, including more LGBTQ+-related education and extracurricular activities, was a desired change by trainees in the study.1 As trainees and faculty, we all have a role in improving the learning environment of trainees. Here we share 3 successful trainee and faculty collaborative efforts we have implemented to improve the learning climate and inclusivity of LGBTQ+-identified medical trainees at Stanford. First, we have built a formal “out list” of faculty who openly identify as LGBTQ+. The out list is accessible only behind a school login, and importantly, while faculty members are encouraged to identify openly, students retain the option to engage with and contact faculty anonymously. Visibility and mentorship by LGBTQ+-identified faculty may be crucial in cultivating a learning environment where LGBTQ+ students thrive. Second, since 2016, we have developed a sexual and gender minority (SGM) health longitudinal curricular theme. This curricular strand incorporates the essentials of a respectful history taking and physical examination tailored to SGM communities. The course includes anti-bias training and aims to correct misconceptions about SGM patients with the intent of cultivating future physicians competent in SGM health. Medical students serve as teaching assistants, contributing to curricular leadership and innovation. Understanding the unique health needs of SGM patients is fundamental to medical education. Third, we have conducted The Real Deal annual survey for nearly the past 10 years, serving as both a reflective and educational tool. The anonymous opt-in survey captures demographics and beliefs about LGBTQ+ individuals within the student body. Once the results are collected, a medical student team puts together a presentation describing the sexual and gender diversity within the class, using the results as a discussion launchpad aimed at addressing and correcting misconceptions about LGBTQ+ communities. The Real Deal presentation is one of the most cherished and well-attended events by the student body, establishing a safe space for rich discussion about the experience of LGBTQ+ individuals. We welcome collaborations with other institutions and would be eager to share information about the resources we have developed to interested parties. Our hope is that by sharing these efforts we have developed at Stanford, we can contribute to the international commitment of building sustainable, respectful, and enriching learning environments for our LGBTQ+ trainees. Justin L. Jia, MS Medical student, Stanford University School of Medicine, Stanford, California; email: [email protected]; ORCID: https://orcid.org/0000-0003-4843-4548 Adi X. Mukund MD-PhD student, Stanford University School of Medicine, Stanford, California Benjamin H. Laniakea, MD Clinical associate professor of primary care and population health, and chief, Stanford LGBTQ+ Adult Clinical Program, Stanford University School of Medicine, Stanford, California

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