Journal of General Internal Medicine

, Volume 34, Issue 6, pp 893–898 | Cite as

Assessment of Internal Medicine Resident Preparedness to Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Patients

  • Carl G. StreedJrEmail author
  • Helene F. Hedian
  • Amanda Bertram
  • Stephen D. Sisson
Original Research



Recognizing the unique health needs of sexual and gender minorities (i.e., lesbian, gay, bisexual, transgender, queer/questioning individuals) is critical to providing competent and comprehensive healthcare.


To assess resident knowledge of healthcare issues uniquely affecting sexual and gender minorities as well as the role of online case-based didactics to measure and improve knowledge in the diagnosis and treatment of these patients.


A multicenter online education intervention from December 2016 to April 2018.


The study population consisted of 833 PGY1-3 residents at 120 internal medicine residency programs in the USA who completed 1018 tests.


A 1-h online module addressing sexual and gender minority (SGM) health. The test evaluated each resident in four categories: (1) terminology relevant to SGM patients; (2) health disparities and preventive care issues affecting SGM patients; (3) substance use and mental health issues unique to SGM patients; and (4) common sexually transmitted illnesses affecting SGM populations.

Main Measures

Participants completed a pre-test assessing SGM health knowledge. A didactic module reviewing diagnosis and management of these diseases was then completed, followed by a post-test.

Key Results

Among 1018 resident respondents, there was no difference between post-graduate year pre-test performance (PGY-1 52%, PGY-2 50%, PGY-3 51%; p = 0.532) or post-test performance (PGY-1 80%, PGY-2 82%, PGY-3 82%; p = 0.285). Pre-test and post-test performance of an online didactic module was the same across test categories and patient populations for PGY-1 vs. PGY-2 vs. PGY-3. Residents demonstrated an improvement between pre- and post-test knowledge.


Baseline knowledge of health issues of sexual and gender minorities, as assessed by pre-test performance, did not change during residency training. An online didactic module introduced trainees to critical issues regarding the care of these vulnerable populations until such curricula are required in training. Health disparities in LGBTQ communities may improve with improved physician training on clinical care of LGBTQ patients and families.


sexual orientation gender identity medical education 


Compliance with Ethical Standards

Conflict of Interest

The Johns Hopkins University is entitled to payments from purchases of the website curriculum described in this article. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict of interest policies. Dr. Sisson receives an annual stipend for editorial duties payments related to the website curriculum described herein in accordance with Johns Hopkins University technology licensing and conflict of interest policies. All remaining authors declare that they do not have a conflict of interest.

Supplementary material

11606_2019_4855_MOESM1_ESM.docx (32 kb)
ESM 1 (DOCX 32.2 kb)


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Carl G. StreedJr
    • 1
    Email author
  • Helene F. Hedian
    • 2
  • Amanda Bertram
    • 2
  • Stephen D. Sisson
    • 2
  1. 1.Section of General Internal Medicine, Department of Medicine, Boston Medical CenterBoston University School of MedicineBostonUSA
  2. 2.Division of General Internal Medicine, Department of MedicineJohns Hopkins School of MedicineBaltimoreUSA

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