upnorth15,

Your sexual orientation is none of your preceptor's business. If you want to share it feel free, however I do not think it is ever necessary.

Now regarding bigoted comments you need to navigate waters carefully. If you feel comfortable after the moment, always advocate for your community- it's fine to tell an attending it's inappropriate to say those things as long as you understand the consequences.

If I were in this position I would document exactly what was said, when it was said, and who it was said to. I would speak to the attending privately and explain that the comment is inappropriate. Many times they will apologize/acknowledge this. If that attending is going to try to torpedo your grade, it's documented and if you feel it's worth it email your Dean of Student of Affairs this information. If you felt uncomfortable simply explain such. If you medical school does not respond and you believe this is a critical issue, professionally contact the Center for LGBT/Diversity/Underrepresented students etc at your university. However, you do risk being flagged as a problem-child.

The other method is to ignore it, get your grade, and report them anonymously 6-8 months later when your identity is forgotten. I think it depends on your personality, and either choice is fine.

I have privately told attendings/residents their comments are inappropriate and racist- and I suffered for it academically. Was it worth it? Absolutely. Their bigotry is poisonous, and having a group of medical students fearfully nod along is terrifying. The balance is being professional and direct, without insulting their position or intelligence.

All the best,

-wtffng

PS: On the interview trail I may be asked "what happened on this rotation?" I'm not going to tell them I challenged the immoral resolutions of a racist PGY-5 who then bombed my grade- I'm not going to throw the reputation of my institution under the bus due to one bigot. I'm going to say: "You know I was still learning how to work with people with different views, and I think sometimes my stupid-grinning personality was a bit grating to certain people."