Colorectal Surgery Fellows' Perspectives on LGBTQIA+ Patient Care: Identifying Specific Educational Deficits

The current study aimed to describe the prior experiences of colorectal fellows in providing care to patients who identify as part of the LGBTQIA+ community or broader sexual and gender minority (SGM) populations, evaluate fellows' perceptions of the clinical relevance of such care, and identify specific areas relevant to colorectal surgery in which fellows feel inadequately prepared.

This was a cross-sectional study utilizing written survey responses.

Surveys were obtained anonymously and voluntarily at a colorectal fellowship career course.

Fellows enrolled in accredited colorectal surgery fellowship programs during the 2024 to 2025 academic year who attended a career course were eligible to participate. Of 117 ACGME-accredited fellows, 85 attended the course and 65 (76.47%) completed the survey.

The majority of respondents had received some form of SGM-related training in medical school (66.15%) and residency (59.46%), most commonly in didactic format. However, only 24.61% felt this training was adequate. Over 90% of fellows indicated there were aspects of caring for LGBTQIA+ patients they wished they knew more about. While 89.23% agreed that tailored care for LGBTQIA+ patients was important in colorectal surgery, only 56.9% felt confident discussing sexual health and postoperative outcomes with these patients. Prior exposure to tailored LGBTQIA+ care during fellowship was significantly associated with higher confidence (p = 0.02), whereas demographic characteristics and prefellowship training were not.

Colorectal fellows recognize the relevance of LGBTQIA+ patient care but report significant gaps in training and confidence. These findings highlight the need for structured, specialty-specific education that incorporates both didactic and experiential learning. Integrating targeted LGBTQIA+ healthcare training into colorectal surgery fellowships may improve provider preparedness and promote inclusive, patient-centered care.