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The Presence of Implicit Gender Bias in Colon and Rectal Surgery Residency Letters of Recommendation

2023; Lippincott Williams & Wilkins; Linguagem: Inglês

10.1097/dcr.0000000000002633

1530-0358

Ali Al Jabri, Hina F. Bhat, Jonathan S. Abelson, Elizabeth Breen, Angela H. Kuhnen, Sharon L. Stein, Emily Steinhagen, Julia T. Saraidaridis,

Gender Diversity and Inequality

BACKGROUND: Selection for colorectal surgery residency relies upon letters of recommendation for subjective assessment of candidates’ strengths and weaknesses. It is unclear if this process incorporates implicit gender bias. OBJECTIVE: To assess the presence of gender bias in letters of recommendation for colorectal surgery residency. DESIGN: Mixed methods assessment of the characteristics described within the blinded letters of the 2019 application cycle to a single academic residency. SETTINGS: Academic medical center. PATIENTS/STUDY SUBJECTS: Blinded letters from the 2019 colorectal surgery residency application cycle. INTERVENTIONS: Characteristics of the letters were determined using qualitative and quantitative measures. MAIN OUTCOME MEASURES: Association of gender with the presence of descriptors within the letters. RESULTS: There were 111 applicants, 409 letter writers, and 658 letters were analyzed. 43% of applicants were female. Female and male applicants had equal mean number of positive (5.4 vs. 5.8; p = 0.10) and negative (0.5 vs. 0.4; p = 0.07) attributes represented. Female applicants were more likely to be described as having poor academic skills (6.0 vs. 3.4%, p = 0.04) and possess negative leadership qualities (5.2% vs. 1.4%; p < 0.01) than male applicants. Male applicants were more likely to be described as being kind (36.6% vs. 28.3%; p = 0.03), curious (16.4% vs. 9.2%; p = 0.01), possessing positive academic skills (33.7% vs. 20.0%; p < 0.01), and positive teaching skills (23.5% vs. 17.0%; p = 0.04). LIMITATIONS: This study analyzed a single year of applications to an academic center and may not be generalizable. CONCLUSION: There are differences in the qualities used to describe female versus male applicants in colorectal surgery residency application letters of recommendation. Female applicants were more often described in negative academic terms and possessing negative leadership qualities. Males were more likely to be described as kind, curious, academically impressive, and possessing good teaching skills. The field may benefit from educational initiatives to reduce implicit gender bias in letters of recommendation.