The Influence of Applicant and Reviewer Gender on Resident Selection for Internal Medicine

Abstract

Background: While gender bias in medicine, including physician training, has been well described, less is known about gender bias in the selection process for post graduate residency training programs. This analysis reviews the potential role of gender on resident selection for an internal medicine residency program. Methods: File review and interview overall and component scores were analyzed based on the gender of the applicant. File review scores were further analyzed based on the reviewer’s gender. Results: Women applicants scored higher than men applicants on their file review. There were no differences in any one component score except for leadership in art. Women file reviewers scored applicants higher than men file reviewers, but there was no difference between gender scores. There was no difference in overall or component interview scores between men or women applicants. Scoring did not impact the expected rank performance of applicants based on gender at any stage of the selection process. Conclusions: While higher scores were observed in women applicants upon their file review, and women reviewers provided higher file review scores, this did not appear to impact the expected number of women and men applicants at each stage of the applicant process. This suggests a potential lack of gender bias at these stages of applicant selection.

Literature Review on Regulatory Frameworks for Addressing Discrimination in Clinical Supervision

“…Six articles recommended training for supervisors to reduce bias and discrimination. Cultural competence training was encouraged (Barrett et al, 2020; Kristoffersson et al, 2021) to include awareness of one’s own cultural beliefs and biases (Ellis & Robbins, 1993; Kristoffersson et al, 2021). Antidiscrimination training was also suggested (Kleintjes & Swartz, 1996).…”

“…Thirteen articles indicted race as the basis for discriminatory practices in supervision. Yuce et al (2020), Constantine and Sue (2007), Davis (2017), Hu et al (2019), Kleintjes and Swartz (1996), Kristoffersson et al (2021), Nguemeni Tiako et al (2021), Nilsson and Duan (2007), Senreich and Dale (2021), Thackwell et al (2016), and McKenzie-Mavinga and George (2020) discussed the racial disparities that exist within the supervisory relationship. Most indicated experiencing everyday racism and different standards on evaluations than their White counterparts (Yuce et al, 2020).…”

“…Participants in the Bertsch However, Ellis and Robbins (1993) concluded discrimination in supervision rooted in gender is problematic for both male and female supervisees. Notably, of all of the articles assessing gender discrimination, Katz (2021) was alone in finding no evidence to support gender discrimination related to scoring and selecting candidates for medical residence. Katz (2021) stated, "scoring did not impact the expected rank performance of applicants based on gender at any stage of the selection process" (p. 1).…”

“…These articles presented a holistic perspective of the supervisory process and commented on points of vulnerability for supervisees to experience discrimination. Some examined the bias in the application process and the recruitment and selection of trainees that disadvantage minoritized populations (Balon et al, 1997;Beddoe, 2015;Katz, 2021). Others proposed additional structures in the licensure process.…”

“…McKenzie-Mavinga and George (2020) recommended organizational change that allows White supervisors to hold space for the impact of racism on Black supervisees. Other articles highlighted the complexity of addressing discrimination and emphasized the need for multidimensional strategies (Griffith et al, 2019;Villanueva et al, 2021) to include individual and systemic changes (Harpe et al, 2021;Katz, 2021;Yuce et al, 2020). Articles advocated for adopting zero-tolerance policies for discrimination (Kristoffersson et al, 2021;Szafran et al, 2021).…”