ArticleJournal of graduate medical education2021
Race and Gender Bias in Internal Medicine Program Director Letters of Recommendation.
Article in Journal of graduate medical education, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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Who cites it
23 citing papers in PubMed.
- Characteristics and Success of Internal Medicine Applicants to Subspecialty Fellowships.Journal of general internal medicine · 2026Article
- Residency Program Perceptions of Clerkship Pass/Fail Grading: A Program Director Survey at a Multi-center Institution.Journal of general internal medicine · 2026Article
- Evaluation of Gender Bias in Psychiatry Residency Letters of Recommendation.Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry · 2026Article
- Be AWARE: An Anti-bias Toolkit to Limit Bias in Narrative Evaluation of Medical Trainees.MedEdPORTAL : the journal of teaching and learning resources · 2026Article
- Language Differences by Race in the Narrative Section of the Emergency Medicine Standardized Letter of Evaluation.The western journal of emergency medicine · 2025Article
- Differences in language used to describe racial groups in emergency medicine standardized letter of evaluation.AEM education and training · 2025Article
- The Impact of Applicant Sex on Pulmonary and Critical Care Medicine Fellowship Letters of Recommendation: A Multisite Study.ATS scholar · 2025Article
- Are We There Yet? Equity in the Pulmonary and Critical Care Medicine Fellowship Application Process.ATS scholar · 2025Article
- Investigating the Road to Equity: A Scoping Review of Solutions to Mitigate Implicit Bias in Assessment within Medical Education.Perspectives on medical education · 2025Article
- Cultivating Diversity, Equity, and Inclusion in Pulmonary and Critical Care Training: A Path Toward Health Care Excellence.Critical care clinics · 2024Review
- Selection and Recruitment Strategies among Competitive Pediatric Training Programs and the Impact of Diversity.Academic pediatrics · 2024Article
- Gender influences resident physicians' perception of an employee-to-employee recognition program: a mixed methods study.BMC medical education · 2024Article
- Measuring and Predicting Faculty Consensus Rankings of Standardized Letters of Evaluation.Journal of graduate medical education · 2024Article
- Decoding the Reference Letter: Strategies to Reduce Unintentional Gender Bias in Letters of Recommendation.MedEdPORTAL : the journal of teaching and learning resources · 2024Article
- Evaluation of Family Medicine Residency Programs for Diversity, Equity, and Inclusion Milestones.Family medicine · 2024Article
- Gender and culture bias in letters of recommendation for computer science and data science masters programs.Scientific reports · 2023Article
- A primer on writing a narrative letter of recommendation for medical students applying to residency.AEM education and training · 2023Article
- Inclusion, Diversity, Access, and Equity in Infectious Diseases Fellowship Training: Tools for Program Directors.Open forum infectious diseases · 2023Article
- Differences in international medical graduates' letters of recommendation by gender in pulmonary and critical care medicine: a cohort analysis.BMC medical education · 2023Article
- The Transition From Residency to Fellowship: Enhancing Training by Increasing Transparency.Arthritis & rheumatology (Hoboken, N.J.) · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile program director (PD) letters of recommendation (LOR) are subject to bias, especially against those underrepresented in medicine, these letters are one of the most important factors in fellowship selection. Bias manifests in LOR in a number of ways, including biased use of agentic and communal terms, doubt raising language, and description of career trajectory. To reduce bias, specialty organizations have recommended standardized PD LOR.
objectiveThis study examined PD LOR for applicants to a cardiology fellowship program to determine the mechanism of how bias is expressed and whether the 2017 Alliance for Academic Internal Medicine (AAIM) guidelines reduce bias.
methodsFifty-six LOR from applicants selected to interview at a cardiology fellowship during the 2019 and 2020 application cycles were selected using convenience sampling. LOR for underrepresented (Black, Latinx, women) and non-underrepresented applicants were analyzed using directed qualitative content analysis. Two coders used an iteratively refined codebook to code the transcripts. Data were analyzed using outputs from these codes, analytical memos were maintained, and themes summarized.
resultsWith AAIM guidelines, there appeared to be reduced use of communal language for underrepresented applicants, which may represent less bias. However, in both LOR adherent and not adherent to the guidelines, underrepresented applicants were still more likely to be described using communal language, doubt raising language, and career trajectory bias.
conclusionsPDs used language in a biased way to describe underrepresented applicants in LOR. The AAIM guidelines reduced but did not eliminate this bias. We provide recommendations to PDs and the AAIM on how to continue to work to reduce this bias.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.