A comparison of the racial and ethnic representation of applicants and matched residents from competitive medical and surgical specialties, including otolaryngology, found that six of the 11 specialties studied showed a significantly higher proportion of White matched residents compared with applicants. All 11 specialties had significantly fewer proportions of individuals known to be underrepresented in medicine among matched residents compared with applicants.

Physician’s Weekly interviewed Randall A. Bly, MD, about the results, which were published in JAMA.

Physician’s Weekly: What prompted this research?

Dr. Bly: In previous research, my colleagues and I described the many steps involved in the process of applying to residency programs and the factors that influence who is chosen. Following that research, I became really interested in equity and moving toward representation that encompasses the general public
because we’re not there yet.

PW: What were the primary results?

Dr. Bly: We had findings from two groups: the application pool and the accepted pool. When we looked at the application group compared with the accepted group, we found that—for most of the 11 specialties we included the proportion of White matched residents was significantly higher than the proportion of applicants in 54.5% of the specialties. Conversely, the number of matched, under-represented residents was significantly
less than the number of applicants across all 11 specialties.

This is a very complex problem, but data on this topic are limited. I would consider these results to be baseline data about where, exactly, these discrepancies in the racial and ethnic representation of matched residents are arising.

PW: How can the under-representation of non-White individuals be addressed?

Dr. Bly: One practical thing we’ve done at the University of Washington is institute what’s called the distance traveled question. With this approach, every applicant has the option to talk about something in their life that has made it, to some degree, a hardship to reach this point. These are things that may not be captured in metrics like board scores, class rank, and the number of publications that someone has. We’re trying to look at the applications more holistically, and this is one very practical approach.