Status of LGBTQ plus Inclusion Using a Multi-Institution Assessment of US Residencies

Introduction: An inclusive residency program is crucial to the recruitment and retention of competitive and diverse applicants. The radiology lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) inclusion audit was published in 2022, which provided a road map for assessing the inclusivity of a program's policies, facilities, culture, and engagement. In this multi-institutional trial, we detail the results of the LGBTQ+ inclusion audit for nine US radiology residency programs. Methods: A volunteer cohort of academic radiology programs was recruited through the Radiology Residency Education Research Alliance. The LGBTQ+ inclusion audit was modified to apply to a multi-institutional study. Participating programs performed the audit from December 2023 to February 2024. Pre- and postaudit surveys were distributed to capture participants subjective assessment of inclusivity at their programs. Results: Nine US radiology residency programs completed the audit. Audit scores ranged from 6 out of 10 to 9 out of 10; no program received a perfect 10 out of 10 score. Inclusive facilities and institutional culture scored highly, with eight of nine programs reporting all milestones met in these areas. The lowest-performing areas were department culture and community engagement with only three of nine and four of nine programs reporting "all milestones met." After the audit, programs overall reported improved self-perceived inclusivity, with postaudit survey scores increasing in areas related to department policy, inclusive facilities, and LGBTQ+ community outreach. Discussion: Participating radiology residency programs demonstrated an overall high level of LGBTQ+ inclusivity; however, all programs identified inclusion shortcomings in department policy and practice. Intentional review of a department can be a helpful tool to promote a welcoming and healthy environment for a diverse radiology practice.