When students graduate from medical school, the core document in their application to residency programs is the Medical Student Performance Evaluation (MSPE). A new study by Yale School of Medicine faculty reveals differences in how candidates were described in MSPEs based on their race, ethnicity, and gender.
White applicants were more likely than Blacks, Hispanics, and Asians to be described with adjectives like “exceptional,” “best,” and “outstanding,” while Black applicants were more likely to be described as “competent,” according to the study, published online August 9 in the journal PLOS ONE.
The study also found that female applicants were more frequently described as “caring,” “compassionate,” and “empathetic.” The adjectives “bright” and “organized” were used more frequently to describe women.
“While the MSPE is intended to reflect an objective, summative assessment of students’ qualifications, these data demonstrate for the first time systematic differences in how candidates are described based on group membership,” said David A. Ross, MD, PhD, Associate Professor of Psychiatry at Yale and the study’s first author. “Recognizing possible implicit biases and their potential impact is critical both for the individuals writing these letters and for Program Directors who are reading them and making important admissions decisions based on what they contain.”
The authors used custom software to analyze the language in MSPEs from 6,000 men and women from 134 medical schools who applied to 16 residency programs at the Yale School of Medicine during the 2014-1015 application cycle.
The applicants’ median age was 26, and 45 percent were women. Seven percent were Black, 4 percent were Hispanic, 24 percent were Asian and 55 percent where White.
Researchers discovered significant differences in the use of the standout words “exceptional,” “best,” and “outstanding,” with White applicants being more likely than Blacks, Hispanics, and Asians to be described by those adjectives. They found Whites were also statistically more likely than Blacks, Hispanics, and Asians to be described as “bright.”
The adjective “competent” was used more frequently to describe Blacks than any other racial or ethnic group. An analysis of the context of the word’s use revealed it had a positive connotation 37 percent of the time when describing Blacks compared to 33 percent for Hispanics, 57 percent for Whites, and 60 percent for Asians.
“This work is an important first step in exploring one key aspect of the residency application process,” Ross said. “It sets the stage for future research that can better characterize the nature and cause of these differences and also to investigate other potential disparities throughout the medical education pipeline.”
The other contributors to the study from Yale were Dowin Boatright, MD, MBA; Marcella Nunez-Smith, MD, MHS; Ayana Jordan, MD, PhD; and Adam Chekroud, MSc. Senior author, Edward Moore, PhD, is an Associate Professor at Central Connecticut State University and an Assistant Professor Adjunct in the Yale Department of Psychiatry.