Ashley Schaffer, MD FAAP (she/her)
Pediatrics Residency - Rutgers Robert Wood Johnson (2012-2015)
Medical School - Saint Louis University School of Medicine (2008-2012)
I have always loved interacting with kids and spending time around them. Before medical school, I had a long history of working with them as a nanny, in daycare settings, and as a summer camp counselor. During my clinical rotations, I enjoyed Family Medicine and OBGYN but, when I really reflected on those experiences, I realized that the parts I enjoyed were all related to Pediatrics in some way - seeing kids and adolescents in Family Med, gynecology, newborn care, etc. When I finally had my Pediatrics rotation later that year it all clicked for me.
When you applied to residency how did you navigate the conversation around gender identity/sexual orientation?
I applied to residency 10 years ago, but I’ve been on the other end of things as an interviewer much more recently. My general advice to students on this topic would be that you don’t have to talk about it if you don’t want to, but you absolutely should if you do want to! Only you can decide what level of disclosure feels comfortable and safe for you. Just remember that part of your role in the interview is to sell yourself to the residency program by discussing your strengths and career goals. Your personal identity and experiences are important but there should be some context to how you relay that information.
In my case, I spoke about my orientation in the context of being co-founder and president of the student LGBTQIA+ group at my medical school. Some interviewers asked me directly about the group and others didn’t, but then I would look for an opportunity to bring it up myself since it was my primary extracurricular activity and leadership experience. When I spoke about it, I tried to keep the focus on my leadership role (for example, I had anecdotes from my time as president to use for “tell me about a challenge/difficult situation” -type questions) and how the kinds of programming we did (wellness events, queer health education, adolescent medicine, etc) would impact my interests in residency. I practiced these answers ahead of time because I was worried that it might get uncomfortable with an interviewer and I wanted to avoid being flustered about it. On one occasion, an interviewer did awkwardly try to ask me, “So…that means you’re uh…👀...” and I was able to smoothly respond “Yes, I’m bisexual” and segue back into how I had networked with other queer students and faculty to found the group at my school.
What change in medicine would you like to see to make it more inclusive for LGBTQIA+ individuals?
I will be frank here and say that I think many areas of medicine are still dominated by a “boys club” attitude that is toxic and exclusionary for all minority groups. Encouraging women, queer people, and BIPOC to pursue more leadership roles, in particular within academic medicine, would be a great place to start. Supporting them and allowing them to reshape the culture once they get into those roles would be even better. For the LGBTQIA+ community specifically, I think that more sexual health and queer health topics need to be integrated into medical education curricula. In medical school, I mostly learned about queer identities in the context of HIV or troubled adolescents. Now, I knew better because of my personal experiences, but what did my cis straight classmates take away from those lectures? How did that limited educational scope impact their personal biases with future patients and queer colleagues? Curriculum reform is possible but, again, we need to foster more representation in academic leadership to make that happen.
What should an LGBTQIA+ applicant look for while selecting programs?
I’m going to start here with what I tell every applicant is most important - Location! Do you actually want to live where this program is? If not, do not rank them! Yes, you’re going to be at the hospital all of the time, but where you’re living and spending your precious time off is going to negatively affect you if you hate it. For LGBTQIA+ applicants specifically, it’s unfortunately becoming more and more important to consider what state a program is in. Research current and potential anti-LGBTQ+ legislation in that state and plan accordingly. No program is worth losing access to your HRT, reproductive healthcare, or potentially having your marriage invalidated.
The second most important thing I tell everyone to consider - The people! Who did you meet during your interview day? Did the residents seem stressed and rushed during your time with them? Were they friendly and open to answering your questions? Can you see yourself spending most of your time with them for the next 3 years? What about your interviewers? Were they prepared? Did they give you an opportunity to ask questions? For lack of a better word, the “vibe” of the program and its people is important to pay attention to. How did you feel when the day was over and you left? For queer applicants, if anyone seemed uncomfortable around you or reacted negatively to your identity/orientation then that is obviously a huge red flag. On the other hand, if you meet an openly LGBTQIA+ resident or attending then that's a green flag and a great opportunity to ask more specific questions about comfort/safety within that program's culture.