Abstract
<title>Abstract</title> <p>Purpose: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) applicants–who report higher rates of mistreatment in surgical training–face unique challenges when evaluating residency program inclusivity. This study explored LGBTQ+ surgery residents’ experiences assessing program climate during virtual interviews. Methods: From August to November 2024, 14 general surgery residents completed 2-on-1 semistructured interviews via Microsoft Teams. Interviews were recorded and transcribed, then analyzed using the Delve Qualitative Analysis Software. Using an inductive analytic approach was used to identify themes and subthemes. Results: Fourteen general surgery residents participated, with median age 30 [IQR, 29–31] years, and identified as male (n = 5), female (6), nonbinary (2). Sexual orientations included gay (5), lesbian (3), bisexual (2), and queer (3). Five majors themes described the unique concerns of LGBTQ+ applicants during the NRMP process: (1) location and community, (2) decisions surrounding disclosure of LGBTQ+ status, (3) limitations of virtual interviews in assessing inclusivity (4) need to evaluate programs through more informal cues and (5) expectations of program to demonstrate diversity, equity, and inclusion. Subthemes aligned with the distinct stages of the NRMP process–application, interviews, ranking, and program integration–illustrating how these factors influence applicants’ perceptions and decision-making. Conclusion: General Surgery applicants must consider multiple factors when evaluating residency programs. Our findings suggest that LGBTQ+ applicants face notable challenges when evaluating program inclusivity, particularly in the setting of virtual interviews, emphasizing the need for programs to more clearly demonstrate their culture and commitment to diversity.</p>