Abstract
Objective
To describe differences in agentic (achievement) and communal (relationship) terms
in letters of recommendation (LORs) for pediatric residency candidates by applicant
and letter writer demographics and to examine if LOR language is associated with interview
status.
Methods
A random sample of applicant profiles and LORs submitted to one institution were analyzed
from the 2020-21 Match. LOR text was inputted into a customized natural language processing
application which determined the frequency of agentic and communal words in each LOR.
Neutral LORs were defined as having <5% surplus of agentic or communal terms.
Results
We analyzed 2,094 LORs from 573 applicants: 78% were women, 24% under-represented
in medicine (URiM), and 39% invited to interview. Most letter writers were women (55%)
and of senior academic rank (49%). Overall, 53% of LORs were agency biased, 25% communal
biased, and 23% neutral. There was no difference in agency and communally biased LORs
by an applicant’s gender (Men 53% agentic vs. Women 53% agentic, p=.424), race or
ethnicity (Non-URiM 53% agentic vs. URiM 51% agentic, p=.631). Male letter writers
used significantly more agentic terms (8.5%) compared to women (6.7% agentic) or writers
of both genders (3.1% communal) (p=0.008). Applicants invited to interview were more
likely to have a neutral LOR, however, no significant association existed between
language and interview status.
Conclusions
No significant differences in language were found by applicant gender or race among
pediatric residency candidates. Identifying potential biases within pediatric residency
selection processes is important in creating an equitable approach to application
review.
Keywords
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References
National Resident Matching Program, Data Release and Research Committee: Results of the 2021 NRMP Program Director Survey. 2021. 〈https://www.nrmp.org/wp-content/uploads/2021/11/2021-PD-Survey-Report-for-WWW.pdf〉. Accessed March 2022.
- The big two dictionaries: Capturing agency and communion in natural language.Eur J Soc Psychol. 2019; 49: 871-887
- Ethnic/Racial Bias in Medical School Performance Evaluation of General Surgery Residency Applicants.J Surg Educ. 2021;
- Race and Gender Bias in Internal Medicine Program Director Letters of Recommendation.J Grad Med Educ. 2021; 13: 335-344
- Differences in Narrative Language in Evaluations of Medical Students by Gender and Under-represented Minority Status.J Gen Intern Med. 2019; 34: 684-691
- Agentic traits are associated with success in science more than communal traits.Pers Individ Dif. 2017; 106: 6-9
- “I think it, therefore it’s true”: Effects of self-perceived objectivity on hiring discrimination.Organ Behav Hum Decis Proc. 2007; 104: 207-223
- Science faculty’s subtle gender biases favor male students.Proc Natl Acad Sci. 2012; 109: 16474-16479
- Why is John More Likely to Become Department Chair Than Jennifer?.Trans Am Clin Climatol Assoc. 2015; 126: 197-214
- Gender and letters of recommendation for academia: agentic and communal differences.J Appl Psychol. 2009; 94: 1591-1599
- Influence of Gender on Surgical Residency Applicants' Recommendation Letters.J Am Coll Surg. 2019; 228e353
- The Presence of Gender Bias in Letters of Recommendations Written for Urology Residency Applicants.Urology. 2019; 134: 56-61
- Gender Differences in Language of Standardized Letter of Evaluation Narratives for Emergency Medicine Residency Applicants.AEM Educ Train. 2017; 1: 334-339
- Do gender and racial differences exist in letters of recommendation for obstetrics and gynecology residency applicants?.Am J Obstet Gynecol. 2021; 225 (554.e551-554.e511)
Forth T. Gender Bias Calculator. 〈https://www.tomforth.co.uk/genderbias/〉. Published 2013. Accessed February 2021 .
- Gender-Based Linguistic Analysis of Pediatric Clinical Faculty Evaluations.Acad Pediatr. 2022; 22: 324-331
Pediatric Physicians Workforce Data Book, 2020-2021. Chapel Hill, NC: American Board of Pediatrics; 2021. 〈https://www.abp.org/sites/public/files/pdf/workforcedata2020-2021.pdf〉. Accessed Feb 15, 2022 .
- Are There Gender-based Differences in Language in Letters of Recommendation to an Orthopaedic Surgery Residency Program?.Clin Orthop Relat Res. 2020; 478: 1400-1408
Assocation of American Medical Colleges. Diversity in medicine: facts and figures. 2019. 〈https://www.aamc.org/data-reports/workforce/interactive-data/figure-13-percentage-us-medical-school-graduates-race/ethnicity-alone-academic-year-2018-2019#:~:text=The%20largest%20proportions%20of%20medical,%2FEthnicity%20(8.0%25)%20individuals〉. Accessed Aug 15, 2022 .
Accreditation Council for Graduate Medical Education. Data Resource Book. Academic Year 2020-2021. 〈https://www.acgme.org/globalassets/pfassets/publicationsbooks/2020-2021_acgme_databook_document.pdf〉. Accessed Aug 15, 2022 .
- Differences in words used to describe racial and gender groups in Medical Student Performance Evaluations.PLoS One. 2017; 12e0181659
- Physicians' implicit and explicit attitudes about race by MD race, ethnicity, and gender.J Health Care Poor Underserved. 2009; 20: 896-913
- Gender and Racial Bias in Radiology Residency Letters of Recommendation.J Am Coll Radiol. 2020; 17: 64-71
- Improving Diversity in Pediatric Residency Selection: Using an Equity Framework to Implement Holistic Review.J Grad Med Educ. 2021; 13: 195-200
- Implementation of holistic review into emergency medicine residency application screening to improve recruitment of underrepresented in medicine applicants.AEM Educ Train. 2021; 5 (S10-s18)
Article info
Publication history
Accepted:
February 27,
2023
Received:
October 31,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc.
