Research shows LGBTQ+ med students face tougher circumstances in school than straight peers

Researchers from Yale, NYU, and the Universidad Central Del Caribe School of Medicine in Puerto Rico have found that LGBTQ+ medical students struggle more in the demanding medical school environment compared to their heterosexual counterparts.

In their study, ‘Intersectionality of Sexual Orientation, Race, and Ethnicity in Medical School Attrition,’ they discovered that LGBTQ+ medical students leave or are expelled from medical school at twice the rate— or, specifically for lesbian, gay, and bisexual Hispanic students, five times—compared to their straight white peers. The authors note, “This cross-sectional study revealed high attrition rates among LGB medical students, with the highest observed among LGB Hispanic male and female students.”

Their findings underscore the significance of intersectionality in understanding medical school attrition. Despite the need for further studies to explore the reasons behind these disparities, the research suggests that LGB students face discrimination in medical training settings, which may contribute to attrition risks, according to ‘LGBTQ Nation’.

Previous studies referenced by the authors show that lesbian, gay, and bisexual students face a disproportionate amount of mistreatment in medical schools, which includes a range of abusive behaviours such as “discrimination, assault, verbal abuse, and sexual harassment.”

This mistreatment is linked to negative outcomes like burnout, depression, alcohol abuse, increased cynicism, and medical school attrition, with severe effects on women, ethnic/racial minorities, and sexual minorities.

The study suggests that some elevated attrition rates might stem from preconceived attitudes and challenges students face as they enter medical school.

“Members of both the LGB and Hispanic communities may encounter less supportive attitudes toward homosexuality, often more prevalent among recent immigrants or first-generation households, and traditional cultural values around notions of masculinity, authority, and gender roles, perpetuating rigid expectations around sexuality and gender expression and alienating Hispanic LGB students,” the researchers explain.

Medical education has not explicitly addressed Hispanic-specific discrimination issues, inadvertently reducing support for Hispanic students. Future qualitative studies should explore these intersecting challenges and address the heightened attrition rates.

The research also highlights that bisexual medical students had a higher attrition rate (4.2%) compared to lesbian and gay students (3.7%), and all LGB students had a higher rate than non-LGB students (2.4%).

Male students had a higher attrition rate than female students (2.8% vs. 2.2%), and Asian, Black, and Hispanic students experienced higher rates (2.2%, 4.7%, 4.7%, respectively) compared to white students (2.0%).

There was a strong correlation between students' performance on the MCAT entrance exam and their dropout rate, with the lowest quartile scoring an attrition rate of 4.5%, while the highest quartile had a rate of only 1.4%.