Discriminatory questions asked during residency programme interviews: perspective from both interviewers and...

Area of Science:

• Medical Education
• Residency Recruitment
• Healthcare Disparities

Background:

• The National Resident Matching Program (NRMP) mandates that interviewers avoid discriminatory questions, but compliance remains a significant issue.
• Existing policies have not fully prevented the introduction of illegal or coercive questions during residency interviews.

Purpose of the Study:

• To assess the prevalence of discriminatory and coercive topics during residency interviews.
• To evaluate the effectiveness of different training methods on interviewer behavior and understanding of non-discriminatory practices.

Main Methods:

• Surveys were administered to 18,187 medical students and 481 residency interviewers across 21 specialties during the 2015-2016 residency match.
• The study analyzed the frequency of discussions on sensitive topics and interviewers' comprehension of discriminatory content.

Main Results:

• Discriminatory topics, particularly age and gender, were frequently discussed in interviews, especially in surgical and competitive specialties.
• Nearly half of interviewers discussed potentially coercive topics, and a majority considered them in candidate evaluations, indicating widespread misunderstandings.
• Combined oral and written interviewer training significantly improved adherence to non-discriminatory practices and accurate identification of sensitive topics.

Conclusions:

• The persistent presence of explicit discrimination in residency recruitment is concerning, particularly given the focus on differential attainment.
• Formal interviewer training shows promise in mitigating discrimination, but a zero-tolerance policy and continuous reinforcement are necessary for effective change.