Should I Disclose My Sexual Orientation on Residency Applications?

Daniel J. Egan, MD

Disclosures

October 11, 2010

Question

Before starting medical school, I worked for 10 years in social services, advocacy, and health education on gay, lesbian, bisexual, and transgender issues. Should I include my work history on my residency applications? I'm concerned that it may lead to questions about my own sexual orientation, but if I leave it off, there will be gaps in my work history. Do you have any advice?

Response from Daniel J. Egan, MD
Associate Residency Director, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY

Thanks for your very honest question. Let me begin by saying that it is a shame that in 2010 this topic still causes anxiety for applicants. I will do my best to give you an honest answer, although ultimately the decision is a deeply personal one in which you must weigh what you perceive to be the advantages and disadvantages.

As you know, residency is a very difficult and challenging time of life. For most people, the amount of time spent at the hospital and on residency-related issues far surpasses the amount of time spent on a personal life. With that in mind, the choice of a residency program and its location are critically important.

It is painfully obvious from watching the news or reading a newspaper that within our country, there are regions and particular cities that are more or less "tolerant," open-minded, liberal, or conservative. You probably have had similar concerns when deciding on a specialty, as different fields have different reputations for openness.

I think the take-home point is to consider whether you are willing to be in a place where you might not feel accepted. We all dream of getting the best training possible, but I think we shortchange our personal needs. This is not the time in your adult life to retreat from your own identity. Although sexuality has nothing to do with your ability to practice medicine, there are some individuals who hold certain prejudices that could make you feel uncomfortable. Don't you want to be in a program where you are welcomed, supported, and included to the same extent as your colleagues? If a program is not ready to embrace your sexual orientation, it likely is not the best place for you to spend the next 3 years of your life.

As for your work history, you must weigh other issues as well. As an associate program director, I would view significant gaps in an applicant's timeline as a red flag. Where were they? What were they doing? Where is their professionalism? To me, the potential downside of omitting those activities far outweighs the downside of including them (such as the potential for discrimination).

That said, I struggle with the applicant who wants to mention something related to sexual orientation simply to have it on the application. If an applicant wants to do this purely to "out" himself or herself, the rationale becomes less clear. Many program directors may understand that these students struggle with acceptance and that they fear matching in a program with a hostile environment. However, the purpose of including this information might be unclear if it was unrelated to the applicant's professional experience.

Instead, this might be something to bring up in an interview. For example, you could ask, "Are benefits open to my partner at your institution?" Or, "What has been the experience of previous lesbian, gay, or bisexual residents in your program?" These are completely legitimate questions that will give you an immediate sense of the program and whether these things are even an issue.

I am hopeful that in a world of highly educated, professional physicians who are committed to the training of future doctors, issues of sexuality would not play a role in the application process. But the reality is that in some places, they do. Fortunately, many of the top residency programs are in metropolitan areas, which tend to have a diverse and accepting population.

I would also encourage you to use the networks that exist through the Gay and Lesbian Medical Association and the American Medical Student Association's Gender and Sexuality Committee to speak with residents and physicians around the country in places where you may want to apply.

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