By Mary Kate Brogan

Training future doctors to be better listeners has become a common part of medical training. They often do this by listening to patients tell their stories.

But some of the most impactful stories third-year medical student Gerald Coronado has heard haven’t come from the classroom. They’ve come from a student organization at Virginia Commonwealth University School of Medicine called Medicine with Pride at VCU.

“They were just telling their story — their experience of being transgender and dealing with health care and medicine,” Coronado said. “A lot of times they were difficult stories about being mis-gendered or having their experiences discounted. I’m grateful that Medicine with Pride was able to have these patients ... I think that’s the best thing -- just to hear the stories from patients themselves.”

Coronado has had years of practice listening to patients, especially those in the LGBTQIA+ community. Before attending VCU, Coronado spent several years in Los Angeles volunteering with groups addressing food security needs of LGBTQIA+ community members and individuals with HIV/AIDS.

Preparing to move to Virginia for medical school, Coronado, who uses he/him and they/them pronouns, wondered whether they’d feel the same acceptance in Virginia as they did in California. Medicine with Pride met that need.

“When I was living in Los Angeles, a large part of my social circle were people who identified as queer,” said Coronado, who identifies as queer, nonbinary and demisexual. “It was nice to know that [MedPride] existed and that I could create a space for [a part of my identity] here as well.”

Working to remove roadblocks to equitable health care

The health care LGBTQIA+ individuals have received in the U.S. and throughout the world has differed historically. Many of these differences are based on social inequities related to stigma, discrimination and denial of human rights. Organizations such as the Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services and the U.S. Preventive Services Task Force have identified the need for health care providers and public health professionals to remedy the health disparities facing this community.

Recommendations by these groups carry tremendous influence among doctors and help shape the way they practice medicine every day.

Increasing visibility

When Coronado arrived at VCU School of Medicine in 2019, they attended a dinner hosted by Medicine with Pride. The student organization seeks to empower sexual and gender minority medical students, increase the number of physicians trained in LGBTQIA-inclusive health care and address the LGBTQIA+ community’s needs through research, advocacy and service.

Coronado was impressed. They served as president of Medicine with Pride from 2019 to 2020. Alongside the group’s treasurer, they worked to increase the presence and visibility of the organization and the students and community it serves.

“It’s about showing students who do identify as queer that they can be visible,” Coronado said. “And that's the first step in making a patient feel more comfortable — knowing they have representation in their physicians and providers.”

During that time, Coronado and the team led the group in volunteering with and inviting speakers from local organizations, such as Health Brigade, the Nations Foundation, Equality Virginia and Transgender Health Alliance of Central Virginia. They brought in patients to hear their stories. They worked to make VCU’s MedPride group the first in Virginia to establish a chapter of the national student organization, Medical Student Pride Alliance. They even advised on the School of Medicine’s LGBTQIA+ curriculum to ensure it was as inclusive and representative as possible, Coronado said.

During their time as a student leader of MedPride, Coronado was invited to be part of a new initiative founded last year: VCU School of Medicine’s Inclusion Council. The council provides perspective and context for how to address racism, other forms of discrimination and health inequities while working to turn meaningful dialogue into action and engagement.

One initiative the council announced earlier this fall was its inaugural OUTlist, of which Coronado is a member in addition to their role as a student representative to the Inclusion Council. The OUTlist is comprised of VCU School of Medicine students, faculty and staff, as well as VCU Health team members and residents, who identify as members of the LGBTQIA+ community. The list is a resource that exists at medical schools and health systems across the U.S. to help prospective and current students and employees get a sense for what it is like to be out at that academic medical center.

A list compiled by Northwestern University in spring 2020 shows fewer than 25 medical schools nationally had OUTlists available, but that number continues to grow.

“The OUTlist was created to promote a positive and inclusive environment for our LGBTQIA+ employees and learners, offering an opportunity for members of this community to connect with individuals with a shared lived experience,” said Peter Buckley, M.D., dean of VCU School of Medicine. “We are incredibly proud of Gerald and the Inclusion Council for their dedication to the development of this resource and grateful to all our faculty, staff and trainees who selflessly put their names forward to be included on this list, increasing the visibility of our LGBTQIA+ community and of the rich diversity that each individual brings to our School of Medicine.”

Coronado has already heard from one individual interested in learning more about the queer experience at VCU and about what it’s been like increasing awareness about LGBTQIA-inclusive health care as a medical student and future physician.

Making an impact

While efforts in the School of Medicine are just some of the many efforts to build a more inclusive environment for all students, faculty and staff across VCU — the Office of Multicultural Student Affairs’ events recognizing LGBTQIA+ History Month this October are another example — Coronado expects these efforts will influence their future as a health care provider.

The opportunity with MedPride sticks out to them as a way that part of their identity has opened a door to further leadership. They’re now the regional director for the Asian Pacific American Medical Student Association and the region chair for the Council of Young Filipinx Americans in Medicine.

“It was through these opportunities with MedPride and then Inclusion Council and OUTlist, creating so much with the administration and with these groups, that led me to become more passionate about leadership and organizations like this,” Coronado said.

Based on their experience, Coronado expects when they go on to practice after graduation that they’ll continue to advocate for patients.

“It’s a big [responsibility]: Being able to advocate for queer patients and in general, patients who are of different identities than myself, just learning the various issues that they’ve faced from their perspective and hearing that experience from the individuals themselves and what they wish could be different. Forming a proper perspective on patients from different backgrounds or different diagnoses, and just recognizing that a lot of these patients just need to be heard and seen as who they are and from where they're coming,” Coronado said. “A big takeaway for me is just making sure I don't impress my own beliefs and assumptions upon a patient.”

And they don’t have to wait until they graduate to make a difference either.

“I just got some feedback today from one of the residents for my internal medicine inpatient rotation,” Coronado said. “And one of the things that he commended me on was how I advocated for one of the patients who I wasn't even caring for — they were just being cared for by the team — because I made the rest of the team aware of the patient's preferred name or nickname, as well as the patient's preferred pronouns, which the team had not been using prior to that. It was cool putting it into action.”

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