Background

Studies in several fields demonstrate gender and racial differences in descriptions of applicants in letters of recommendation. However, gender and racial biases in obstetrics and gynecology residency letters of recommendation are understudied.

Objective

This study aimed to determine whether there are differences in the letters of recommendation written for medical students applying for obstetrics and gynecology residency based on applicant gender and underrepresented in medicine status.

Study Design

We analyzed all letters of recommendation submitted to a single obstetrics and gynecology residency program during the 2019–2020 application cycle using a computerized text analysis software to evaluate the presence of 25 word categories. Multivariable regression was used to compare differences in the frequency of word categories by gender and underrepresented in medicine status. Concurrently, we performed a qualitative content analysis of letters from a random sample of applicants balanced for gender and underrepresented in medicine status and explored emerging themes until thematic saturation was reached.

Results

We analyzed 3060 letters written for 834 applicants, 721 (87%) of whom were women and 198 (24%) of whom were underrepresented in medicine. Men authored 1605 letters (53%). There was no difference in word categories used in letters written for men and women applicants on multivariable analysis. Similarly, there was no word category difference between letters written for applicants who were underrepresented in medicine compared with White and Asian applicants. However, women letter writers used more communal (relationship-oriented) words compared with men letter writers (P<.001). Moreover, on the qualitative analysis of letters from a random sample of 30 applicants, comments about personality traits were frequent in all letters. Comments on surgical skills, work ethic, and leadership were found more in letters for White and Asian applicants, and phrases that were doubt raisers were found more in letters written for underrepresented medicine applicants.

Conclusion

On linguistic analysis, letters of recommendation written for obstetrics and gynecology residency applicants were similar overall compared with applicant race and gender.

中文翻译：

---

妇产科住院医师的推荐信中是否存在性别和种族差异？

背景

多个领域的研究表明，推荐信中对申请人的描述存在性别和种族差异。然而，妇产科住院医师推荐信中的性别和种族偏见尚未得到充分研究。

客观的

本研究旨在确定为申请妇产科住院医师的医学生撰写的推荐信是否存在基于申请人性别和医学状况代表性不足的差异。

学习规划

我们使用计算机文本分析软件分析了在 2019-2020 年申请周期提交给单个妇产科住院医师计划的所有推荐信，以评估 25 个单词类别的存在。多变量回归被用来比较不同性别的词类别频率的差异和在医学状态中代表性不足的差异。同时，我们对来自性别平衡且在医学状况中代表性不足的申请人的随机样本进行了定性内容分析，并探索了新兴主题，直到达到主题饱和。

结果

我们分析了为 834 名申请人写的 3060 封信，其中 721 人 (87%) 是女性，其中 198 (24%) 人在医学领域的代表性不足。男性撰写了 1605 封信件 (53%)。在多变量分析中，为男性和女性申请人写的信件中使用的词类别没有差异。同样，与白人和亚裔申请人相比，为医学领域代表性不足的申请人写的信件之间没有词类差异。然而，与男性写信人相比，女性写信人使用了更多的公共（关系导向）词（P<.001）。此外，在对随机抽样的 30 名求职者的信件进行定性分析时，所有信件中都经常出现关于人格特质的评论。白人和亚裔申请人的信件中更多地发现了对手术技能、职业道德和领导力的评论，而在为代表性不足的医学申请人写的信件中，更多地发现了令人怀疑的词组。

结论

在语言分析方面，与申请人种族和性别相比，为妇产科住院医师撰写的推荐信总体上相似。