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ArticleORL; journal for oto-rhino-laryngology and its related specialties2023

Racial and Ethnic Bias in Letters of Recommendation and Personal Statements for Application to Otolaryngology Residency.

Taylor J Stack, Garrett A Berk, Tiffany D Ho, Abdullah Zeatoun, Keonho A Kong, Mark B Chaskes, Brian D Thorp, Charles S Ebert, Christine E DeMason, Brent A Senior and 1 more

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In one paragraph

Article in ORL; journal for oto-rhino-laryngology and its related specialties, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.5field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Designing and Implementing a Pilot Anti-racism and Structural Competency Assessment for Graduate Medical Admissions.Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry · 2026
    Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Taylor J StackDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Garrett A BerkDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Tiffany D HoDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Abdullah ZeatounDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Keonho A KongDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Mark B ChaskesDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Brian D ThorpDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Charles S EbertDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Christine E DeMasonDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Brent A SeniorDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
Adam J KimpleDepartment of Otolaryngology-Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA.
University of North Carolina at Chapel Hill · US

Funding

North Carolina Translational and Clinical Science Institute (NC TraCS) KL2KL2TR002490 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI WEINBERGER, MORRIS · 2018 to 2022
$11.0M
NCATS NIH HHS KL2 TR002490NCATS NIH HHS KL2TR002490
6 · The paper itself

Abstract

introductionThe persistent lack of racial and ethnic diversity within the field of otolaryngology calls for an analysis of potential bias within the residency application system. Letters of recommendation (LORs) and personal statements (PSs) are the most important subjective application constituents. This subjectivity predisposes these components to implicit bias. In applications to various surgical subspecialties, prior linguistic studies assessing bias in reviews of LOR show race-based differences. Thus far, racial and ethnic linguistic differences in LORs for otolaryngology applicants have not been analyzed in the literature.

methodsLORs and PSs were abstracted from otolaryngology - head and neck surgery applications in the Electronic Residency Application Service for the 2019-20 and 2020-21 application cycles. Linguistic Inquiry and Word Count 2015 was used for quantitative analysis of emotional, cognitive, and structural components of written text.

resultsRace-pair analysis of the 2019-2021 application cycles revealed higher mean "teaching" scores for LORs for Asian, black, Hispanic, and white applicants when compared to applicants who self-identified as Other. White applicants had lower scores for the terms "research" and "analytic" when compared to Asian and black applicants, respectively. Analysis of PSs revealed greater scores for an "authentic" writing style for white versus Asian applicants. White applicants were found to have higher scores for "tone" compared to black applicants.

conclusionMinor racial and ethnic language differences exist in both LORs and PSs. A statistically significant difference was observed among LORs, with the "teaching" term used more frequently for Asian, black, Hispanic, and white applicants compared to self-identified Other individuals. For PSs, statistically significant differences were observed among white applicants, who wrote about themselves using more "authentic" language when compared with Asian applicants and who also had higher scores for "tone" compared to black applicants. Although these differences were statistically significant, the practical impact of the variances is likely small.

Indexed as

Internship and ResidencyOtolaryngologyHumansWritingDiversityLetters of recommendationLinguistic analysisOtolaryngology residency applicationResidency application

Identifiers

PMID37040732
PMCPMC10871677
OpenAlexW4364356156

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.