Canadian Medical Association Journal 1996; 155: 974
"There needs to be some institutional [acknowledgement] that there are gay and lesbian medical students," says Dr. Cathy Risdon, medical director of the North Hamilton Community Health Centre and a faculty member at McMaster University medical school.
Risdon is conducting a study of the experiences of gay and lesbian medical students and residents in Canada. "It's a rare exception to hear people's stories that don't include elements of some very painful and stress-provoking things," she says.
"Medical school and residency are stressful events independent of any other variable. When one is also gay or lesbian going through those, there's an added package for which there's little institutional recognition. In some cases there is active discrimination."
One purpose of her study is to "get feedback from students on what needs to be changed about their work settings and educational settings." Recommendations will then be presented to deans.
It doesn't take much to help medical students feel comfortable. McMaster, for example, now uses "partner," not "husband" or "wife," on invitations, and includes a welcome statement and list of local gay and lesbian resources in its orientation package.
Such simple steps "normalize [homosexuality] to a very large extent," says Dr. May Cohen, retired associate dean of health services at McMaster and chair of the CMA's Gender Issues Committee.
Cohen says the committee first raised the need for "institutional support systems" in 1993. "The issue of homophobia is absolutely front and centre of this whole thing," she says. "That's what we have to be concerned about.
"Gay and lesbian people are not a visible minority. We're sophisticated enough nowadays not to make antiblack jokes in front of black people, but [gay and lesbian students] will frequently hear very derogatory things, jokes and so forth, that are antigay and antilesbian."
She says medical schools' reluctance "to provide an open forum around homosexuality," except when it comes to AIDS, perpetuates the problem. "I would like to see us foster open discussion of this issue," she says. "It really is in the closet."
Vancouver psychiatrist Michael Myers agrees. Myers, a clinical professor at the University of British Columbia, says there is "just a bit more openness and acceptance of homosexuality in our society, as well as in medicine, but there's still a long way to go."
Myers remains "amazed at the number of times" he's heard of attending staff making negative comments about gay patients and "operating on the assumption that the clinical group in front of them are all red-blooded heterosexual men and women."
However, he says such incidents are "less common than what students would define as microinequities. There are lots of microinequities for gay and lesbian medical students because it's a very heterosexist curriculum and approach to patients."