Graduate medical education success depends on program excellence and recruiting appropriate trainees. However, identifying the qualities, strengths, and weaknesses of applicants has become increasingly difficult due to third-party revisions of their applications. While applicants send personal statements and other documents through the Electronic Residency Application Service (ERAS), many are purchasing the services of support businesses, or hired contractors, to review and revise their submissions. These contractors can distort applicant information, increase student debt, and create potential ethical problems. The application process should be transparent and accurate and emphasize applicant input.

For an applicant, entry into a residency program begins with

ABSTRACT

Background

Underrepresented in medicine (UIM) visiting student clerkship scholarships provide an opportunity for supporting diversity. Although these scholarships have become a popular initiative to recruit diverse surgical applicants, they have not been thoroughly analyzed regarding which programs offer scholarships and the characteristics of the scholarships. UIM scholarship opportunity disparities may exist depending on location, funding, reputation, and program size among different specialties.

Objective

To describe the characteristics and prevalence of UIM visiting student scholarships by examining institutional and program websites for the surgical specialties.

Methods

Using the Accreditation Council for Graduate Medical Education (ACGME) Accreditation Data System for 2021, residency training and diversity websites were identified and evaluated for the availability of UIM visiting student scholarships in July 2021. Eight surgical specialties were examined. Scholarships were categorized by how UIM was defined, the funding amount provided, and scholarship application requirements. We analyzed the association of the program's National Institutes of Health funding, size, type, region, reputation, and population density of the program's area via Doximity on scholarship availability using chi-square and multivariate analysis.

Results

Of the 1058 analyzed programs, 314 (29.7%) had a UIM visiting student scholarship. There were 4 different definitions of UIM used among the analyzed programs. The average scholarship amount offered was $1,852.25 ($500-$4,000). Depending on the specialty, different variables were associated with whether a program had a UIM scholarship.

Conclusions

Currently, UIM scholarship offerings were variable between programs and surgical specialties.

ABSTRACT

Background

Studies on components of residency applications have shown evidence of racial bias. The Standardized Letter of Evaluation (SLOE) is an assessment measure for emergency medicine (EM) residency applications and, as more specialties opt to use SLOEs in place of narrative letters of recommendation, understanding bias on standardized assessments is essential.

Objective

To determine whether there is a difference in rankings on the EM SLOE between underrepresented in medicine (UIM) and non-UIM applicants, White and non-White applicants, and to examine whether differences persist after controlling for other characteristics.

Methods

The sample was drawn from medical students who applied to EM residency at the study institution in 2019. We compared rankings between UIM and non-UIM students and between students of each individual race/ethnicity and White students, after controlling for United States Medical Licensing Examination Step scores, Alpha Omega Alpha status, type of school (US MD, US DO, internation medical graduate), Medical Student Performance Evaluation class percentile, affiliated program vs visiting clerkship SLOE, gender and the interaction of race/ethnicity and gender, and adjusted for students submitting multiple SLOEs, using ordinal regression.

Results

There were 1555 applicants to the study institution in 2019; 1418 (91.2%) had a SLOE and self-identified race/ethnicity. After controlling for applicant characteristics, non-UIM students were significantly more likely to be ranked higher than UIM students on “Rank Against Peers,” (OR 1.46, 95% CI 1.03-2.07) and Grade (OR 1.46, 95% CI 1.05-2.04).

Conclusions

Analysis of EM SLOEs submitted to our institution demonstrates racial bias on this standardized assessment tool, which persists after controlling for other performance predictors.

ABSTRACT

Background

The Standardized Letter of Evaluation (SLOE) stratifies the assessment of emergency medicine (EM) bound medical applicants. However, bias in SLOE, particularly regarding race and ethnicity, is an underexplored area.

Objective

This study aims to assess whether underrepresented in medicine (UIM) and non-UIM applicants are rated differently in SLOE components.

Methods

This was a cross-section study of EM-bound applicants across 3 geographically distinct US training programs during the 2019-2020 application cycle. Using descriptive and regression analyses, we examine the differences between UIM applicants and non-UIM applicants for each of the SLOE components: 7 qualifications of an EM physician (7QEM), global assessment (GA) rating, and projected rank list (RL) position.

Results

Out of a combined total of 3759, 2002 (53.3%) unique EM-bound applicants were included. UIM applicants had lower ratings for each of the 7QEM questions, GA, and RL positions. Compared to non-UIM applicants, only some of the 7QEM components: “Work ethic and ability to assume responsibility,” “Ability to work in a team, and “Ability to communicate a caring nature,” were associated with their SLOE. “Commitment to EM” correlated more with GA for UIM than for non-UIM applicants.

Conclusions

This study shows a difference in SLOE rating, with UIM applicants receiving lower ratings than non-UIM applicants.

The Accreditation Council for Graduate Medical Education (ACGME) Council of Review Committee Residents (CRCR) hosted a 1-hour session during the 2022 Annual Educational Conference to promote the inclusion of storytelling and narrative medicine in graduate medical education (GME). The purpose of the session was to foster community, well-being, and humanism through storytelling and narrative medicine, and to provide strategies for incorporating a topic-focused curriculum into GME programs regardless of specialty, duration, or program size.

The ACGME Common Program Requirements for residency programs mandate training programs and their sponsoring institutions address trainee well-being, including “efforts to enhance the meaning that each