Strategies to Counteract Impact of Harmful Bias in Selection of Medical Residents

Abstract

Human biases impact medical care in ways that perpetuate health disparities. Research has demonstrated that biases negatively affect patient outcomes and stifle diversity across the physician workforce, further compounding health disparities by worsening patient–physician concordance. Taken as one, the application, interview, recruitment, and selection processes employed by residency programs has been one of the critical junctures where bias has exacerbated inequities among future physicians. In this article, the authors define diversity and bias, review the history of bias in residency programs’ processes for selecting residents, explore the impact of this history on workforce demographics, and discuss ways to optimize and work toward equity in the practices used by residency programs to select residents.

Josiah Macy Jr. Foundation Conference on Ensuring Fairness in Medical Education Assessment: Conference Recommendations Report

“…A third paper, “Strategies to Counteract Impact of Harmful Bias in Selection of Medical Residents,” 7 explains that residency programs’ application, interview, recruitment, and selection processes are “critical junctures where bias has exacerbated inequities among future physicians.” The paper offers an historical timeline of actions, efforts, and programs in medicine that have generally perpetuated, but in some cases mitigated, harmful bias in medical school and residency program selection processes. The authors begin their historical review with a discussion of the release of the Flexner report in 1910, describing how the report’s overt racism led to the closing of 5 of 7 historically Black medical schools.…”

Demystifying AI: Current State and Future Role in Medical Education Assessment

“…Bias, both explicit and implicit, is another pervasive challenge in the assessment process. [2][3][4][5][6] Both explicit and implicit biases can significantly influence a student's progress by leading to unequal evaluations. These biases often correlate with factors such as gender, ethnicity, and learning styles, thus perpetuating disparities, and making the educational journey less equitable for some.…”

“…The need to identify and neutralize these biases is a pressing concern, one that requires targeted strategies and conscientious attention to assessment structures and strategies. 2,3,7 The transformation of assessment data into meaningful feedback forms a fourth critical challenge. Effective feedback serves as a guide, identifying areas for improvement and reinforcing positive behavior.…”

The Challenge in Building Diverse Ophthalmology Residency Programs

“…Among URiM learners, factors, such as level of diversity within a field, mentors with similar backgrounds, active recruitment into specific fields, and the feeling of identity with stereotypical characteristics of that specialty, all play a role in specialty selection. 6 Currently in ophthalmology, in an effort to mitigate these potential biases and increase the pipeline, we have programs, such as the Raab-Venable Excellence in Ophthalmology Program sponsored by the National Medical Association and the Minority Ophthalmology Mentoring program, the Association of University Professors of Ophthalmology (AUPO), and the American Academy of Ophthalmology. Continued support of these programs and ensuring medical students at every medical school are aware of them is incredibly important.…”