Gender Representation Matters: Intervention to Solicit Medical Resident Input to Enable Equity in Leadership in Graduate Medical Education

Abstract

Problem Gender equity in leadership across academic medicine remains a concern. The case of chief resident (CR) offers an opportunity to explore novel strategies in leadership selection in graduate medical education (GME). Means of identifying potential candidates for CR often rely on faculty assessment of resident performance, yet implicit gender bias has the potential to influence this assessment. Approach To diversify the metrics used in CR selection, an intervention was implemented to solicit resident input to identify candidates for CR at 2 U.S. internal medicine residency programs in 2018 and 2019. This involved a simple, cross-sectional survey of residents in which they were asked to identify individual residents as good candidates for consideration for CR. Outcomes There were 298 of 518 internal medicine resident responses to this intervention across sites and years (mean 58.2% response rate). Nomination patterns of residents and program leaders correlated significantly (correlation coefficient 0.62, P < .001). Controlling for site and year, gender was a significant factor associated with who residents nominated for CR (β-coefficient 0.325, P = .004) with women residents more likely to identify women for CR (odds ratio 1.38, 95% confidence interval 1.11–1.73). Fifty residents nominated themselves for CR, and there was no significant difference by gender (β-coefficient 0.038, P = .91). Next Steps Soliciting resident input to identify candidates for CR may enable gender representation of candidates for this position. Influencing candidate choices may be a promising way to impact leadership selection in medicine.

Association Between Resident Race and Ethnicity and Clinical Performance Assessment Scores in Graduate Medical Education

“…50 Differences in assessment may also impact other outcomes, such as receiving awards, access to and caliber of fellowship training opportunities, and achieving leadership positions such as chief resident. 51,52…”

“…50 Differences in assessment may also impact other outcomes, such as receiving awards, access to and caliber of fellowship training opportunities, and achieving leadership positions such as chief resident. 51,52 In addition, disparities in assessment may have detrimental effects on learner engagement with the profession.…”

Current and future perspectives on smart glasses

“…In addition to education and health fields, smart glasses could empower female specialists as well [24][25][26]. Female ophthalmologists and health specialists could be invited from anywhere in the world without disturbing their household chore schedules and responsibilities.…”

Implementation of a Chief Resident Selection Process Designed to Mitigate Bias: Lessons Learned

“…Chief residency is a considered an honor, and may facilitate a future career in academia and/or professional leadership positions for those selected [1][2][3][4][5][6]. At the same time, the selection process for the chief resident (CR) role varies across programs, is often opaque to the stakeholders and can be vulnerable to various types of biases, which may include affinity or in-group bias, gender bias, and racial and ethnicity biases, among others [1][2][3]7]. Efforts to increase diversity in academic medicine and physician leadership may be aided by an inclusive process that facilitates the selection of a diverse pool of CRs [1][2][3].…”

“…To mitigate bias in CR selection, other approaches are needed. Published recommendations for reducing bias in CR selection include creating a diverse selection committee, seeking input from diverse stakeholders, an open call for applications, and the exclusion of standardized exam scores [1,2,7]. Further strategies recommended to reduce bias in academic recruitment and hiring include the use of structured interviews, holistic review (HR), and explicitly defined selection criteria/rubrics [1,2,11,12].…”