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LGBT Healthcare Professionals' Perspectives on Academia May Lead To Improved Inclusivity

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Dr. Nelson Sanchez

One in five lesbian, gay, bisexual and transgender healthcare trainees and professionals believe their academic medical center doesn't provide a supportive environment to facilitate a successful career, according to a new study led by a Weill Cornell Medical College investigator. The findings underscore the importance of establishing institutional policies that encourage greater diversity and inclusiveness to promote morale, productivity, and faculty retention, and to improve care for a vulnerable and underserved LGBT population.

For the study, published Aug. 3 in the journal LGBT Health, the research team surveyed nearly 350 LGBT doctors, nurses and other healthcare professionals, as well as trainees, to better understand the support they receive and the obstacles they face in academia. Participants who studied or worked in academic medical centers that encouraged scholarship exploring LGBT health concerns, hosted LGBT networking events, and provided mentors that are part of or allied with the LGBT community reported greater personal and professional development than those whose workplaces were less inclusive.

LGBT Steering Committee Promotes Inclusion at Weill Cornell

Weill Cornell Medical College established the LGBT Steering Committee three years ago. The committee organizes mentorship programming, educational modules and social events.

"The committee and website promote visibility and inclusion," said LGBT Steering Committee Chair Dr. Nelson Sanchez, who is gay. "Current and future faculty, staff and trainees need to see that LGBT individuals are present at the institution and we encourage them to be a part of the Weill Cornell family. Dean Laurie Glimcher and Dr. Rache Simmons have been very supportive of LGBT inclusion initiatives at the institution, and thanks to their leadership, Weill Cornell has made significant efforts in improving the climate at the institution."

The committee provides support for LGBT-related research, and it runs safe zone workshops for students and staff to familiarize themselves with LGBT issues, such as LGBT health concerns, LGBT communication skills and on-site LGBT resources. At the end of last year, the committee added sexual orientation and gender identity categories to Weill Cornell's outpatient electronic medical records, becoming one of the few academic health centers to lead this initiative. The committee also helps organize the annual spring LGBT Health Workforce Conference, which provides an overview of current practices so that health professionals can more effectively address the health concerns of LGBT communities.

Last spring, the Weill Cornell Clinical and Translational Science Center collaborated with Dr. Sanchez on its inaugural two-day interactive Cultural Competencies Training on LGBT Communications and Health Needs. The course, open to all students, faculty and staff from CTSC partner institutions, taught participants about local and national LGBT health disparities and best practices in the care of LGBT patients.

The findings demonstrate the value of institutional policies that advance the community's visibility on campus and provide a framework for academic medical centers that want to develop or strengthen such practices. Encouraging greater inclusiveness may also help address critical healthcare disparities among LGBT patients. Healthcare professionals who are also members of that community are especially empowered to help inform and lead the charge in LGBT health advocacy, research, education and service, the authors wrote.

"Institutions need to create programming that makes the environment inclusive for everyone," said lead author Dr. Nelson Sanchez, an assistant professor of clinical medicine at Weill Cornell and an internist at Memorial Sloan Kettering Cancer Center. "We hope that involvement in academia will have a positive impact on health outcomes in the LGBT community and promote diversity missions at our academic medical centers. By bringing their personal perspectives and experiences to academia, LGBT health professionals can help facilitate change. That's really what we hope to accomplish."

For their paper — the first known national study to explore LGBT healthcare professionals' and trainees' perspectives on careers in academic medicine — the investigators surveyed 349 people who attended the LGBT Health Workforce Annual Conference and the Gay and Lesbian Medical Association: Health Professionals Advancing LGBT Equal Annual Conference in 2013. All participants completed written surveys and some participated in focus groups. They were asked to rate their interest in academia as a career, describe their concerns about disclosing their sexual orientation and gender identity, and detail their experiences in academia.

While most participants do not believe that LGBT individuals should keep their identities hidden to advance in academia, they also reported they were less likely to disclose their identities to their professional colleagues than to their friends. They also reported biases against LGBT scholarship and uncertainty about promotion because of their research. Nearly 25 percent of trainees and 22 percent of faculty reported experiencing perceived or real discrimination in the workplace within the past year that interfered with their ability to work or learn due to their sexual orientation.

"This study showed that LGBT health professionals are interested in academia and are very active in LGBT-related teaching, community research, or community service projects," Dr. Sanchez said. "We hope to continue to facilitate this work by making academic medical centers very accepting and welcoming of LGBT health professionals. By promoting diversity and inclusion at our academic medical centers, we can improve faculty retention, promote health-related scholarship, and prepare our trainees for an increasingly diverse patient population."

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