The following is a summary of “Presence of Implicit Gender Bias in Colon and Rectal Surgery Residency Letters of Recommendation,” published in the June 2023 issue of Diseases of the Colon and Rectum by Jabri et al.
Evaluating candidates’ strengths and weaknesses for colorectal surgery residency selection is primarily based on letters of recommendation. It is uncertain whether this procedure incorporates implicit gender bias. This study sought to evaluate the existence of gender bias in letters of recommendation for residency in colorectal surgery. A comprehensive evaluation was conducted using mixed methods to analyze the medical attributes outlined in the anonymized correspondence received during the 2019 application cycle for a specific academic residency program. An academic medical center is a facility that combines medical education and research with patient care received correspondence regarding the 2019 colorectal surgery residency application cycle, specifically about the inability to perceive visual stimuli. The attributes of the letters were assessed using qualitative and quantitative analysis methods—association of sex with the presence of descriptors within the medical records.
A cumulative of 111 candidates, 409 correspondents, and 658 correspondences were examined. About 43% of applicants were of the female gender. Female and male applicants exhibited comparable average numbers of positive (5.4 vs. 5.8; P = 0.10) and negative (0.5 vs. 0.4; P= 0.07) attributes. Female applicants showed a higher prevalence of suboptimal academic skills (6.0% vs. 3.4%; P= 0.04) and demonstrated a greater likelihood of possessing unfavorable leadership qualities (5.2% vs. 1.4%; P < 0.01) compared to male applicants. Male applicants exhibited a higher probability of being characterized as kind (36.6% vs. 28.3%; P = 0.03), curious (16.4% vs. 9.2%; P = 0.01), demonstrating positive academic abilities (33.7% vs. 20.0%; P < 0.01), and demonstrating positive teaching abilities (23.5% vs. 17.0%; P = 0.04).
This study examined a solitary year of applications to an academic center, and its generalizability may be limited. There exist disparities in the characteristics employed to depict female versus male candidates in letters of recommendation for colorectal surgery residency applications. Female applicants were frequently characterized as using unfavorable academic terminology and exhibiting adverse leadership attributes. Males were more likely to be described as benevolent, curious, intellectually exceptional, and possessing commendable pedagogical abilities. The medical field may benefit from educational initiatives to mitigate implicit gender bias in letters of recommendation.