Gay and lesbian physicians in training: Family practice program directors' attitudes and students' perceptions of bias

Background: Disclosure of homosexual orientation by medical students or physicians has generally been regarded as having dire professional consequences. We surveyed family practice residency directors to determine how knowledge of homosexual orientation might affect a residency applicant's ranking. We then surveyed gay and lesbian medical students to better understand their attitudes and beliefs about disclosure of orientation during residency application. Methods: A survey was mailed to all family practice residency directors and a convenience sample of third-and fourth-year guy and lesbian medical students. Results: The program director response rate was 73%. Of these respondents, 67% showed accepting attitudes toward homosexuality, 25% were neutral, and 8% had negative views. One of four directors admitted they 'might rank' or 'most certainly' would rank an applicant known to be gay lower than a heterosexual one. The medical student response rate was 81%. When choosing a specialty, 42 students (71%) considered how other physicians might accept them as a lesbian or gay provider. Psychiatry and family practice were perceived as the most accepting specialties. Thirty-one student respondents (52%) agreed that at most residency programs, an applicant known to be gay or lesbian would be ranked lower than an applicant assumed to be heterosexual. Conclusions: Most family practice residency directors have accepting attitudes toward gays and lesbians in general, but 25% of directors express hesitation in matching openly guy residents. Gay and lesbian medical students want to match in residency programs where they will be welcomed and respected hut fear discrimination if they disclose their orientation.