Gay marriage is the last bastion of to me... as a legal ceremonial sentimental and religious side it's one of the last steps. Retaining your job being one of the earlier steps like not getting kicked out of your job because you're gay.
Medical knowledge and technical savvy are biodegradable. The sort of medicine that was practiced in Boston or New York or Atlanta fifty years ago would be as strange to a medical student or intern today as the ceremonial dance of a !Kung San tribe would seem to a rock festival audience in Hackensack.