Gender bias in postgraduate year one pharmacy letters of recommendation

Abstract

Introduction Letters of recommendation (LORs) are important in pharmacy residency applications. Applicant gender, among other variables, may result in implicit biases that could impact LORs and/or residency attainment. This study hypothesized that LORs have linguistic gender differences in pharmacy residency applications. Objectives The primary objective was to determine if gender‐linguistic differences exist in applicants' LORs. Gender was assessed via the pronouns utilized within the applications. The secondary outcome was to assess LOR linguistic and demographic differences between candidates who did and did not receive interviews. Methods This was a multiyear, multicenter study involving postgraduate year one (PGY1) applicants to participating pharmacy residency programs. Demographic data were extracted using the PhORCAS (Pharmacy Online Residency Centralized Application Service) WebADMIT (Admissions Management System) portal, and LORs were analyzed by validated linguistics processing software. Results A total of 7529 LORs and 2383 applicants (28.5% men, 71.5% women) were included. Women candidates had higher mean number of awards (4.71 vs. 4.1, p = 0.001) and leadership positions (4.87 vs. 4.48, p = 0.019). Compared with men candidates, women had statistically significantly higher levels of clout (p < 0.001), positive emotion (p = 0.01), social processes (p < 0.001), prosocial behavior (p = 0.002), and social referents (p < 0.001). Women also had lower authenticity compared with men candidates (p < 0.001). Two thousand and one hundred twenty applicants included in the secondary analysis found no difference in offer to interview between women and men candidates (odds ratio [OR] 1.173 [95% confidence interval (CI) 0.895–1.57], p = 0.247). Conclusions Men and women applicants' LORS differed in specific linguistic variables, although offer to interview was not significantly different based on gender. LOR writers and programs should consider implicit biases that could affect residency offers to interview.

Navigating power dynamics between pharmacy preceptors and learners

“…Given that “pharmacy is a small world,” students may also feel the pressure to perform due to the dynamic of preceptor to learner where the preceptor may be asked to provide a letter of recommendation for jobs or post-graduate training. 15 , 16 , 17 Verbal recommendations are also common when students are applying for jobs or post-graduate training. Preceptors should be cognizant as they are writing these letters or providing verbal recommendations to minimize the use of verbiage related to gender-bias and unconscious biases given their position of power over the learner.…”

“…Preceptors should be cognizant as they are writing these letters or providing verbal recommendations to minimize the use of verbiage related to gender-bias and unconscious biases given their position of power over the learner. 15 , 16 , 17 , 18 …”

“… 38 Appropriate training can better support learners throughout their education but may also help preceptors in considering their implicit bias when writing letters of recommendation for applicants. 15 Similarly, years of precepting and formal preceptor training can significantly influence clinical teaching behaviors. 33 …”