Does Objective Scoring of Applications for Radiology Residency Affect Diversity?

It is important to recognize if reliance on certain factors in applications affects selection of trainees from under-represented groups. Our purpose is to determine if objective scoring of radiology residency applications based on quantifiable data regarding academic performance, United States Medical Licensing Examination (USMLE) scores and research productivity affects selection of female and under-represented minority (URM) candidates.

We reviewed 502 applications from three successive match cycles from United States allopathic medical students. Each application was scored for academic performance, USMLE results and research productivity determining an overall score. The scores of males were compared to females and URM were compared to non-URM candidates. USMLE cutoff scores were evaluated for disparate effects.

There were 348 male, 154 female, 73 URM and 429 non-URM candidates. For male versus female applicants, there was no significant difference in mean academic performance, USMLE Step 2 Clinical Knowledge and research productivity scores. Males had higher mean USMLE Step 1 (p = 0.005) and overall candidate scores (p = 0.02). Between URM and non-URM candidates there was no significant difference in academic performance. Non-URM applicants had higher mean USMLE Step 1 (p = 0.008), USMLE Step 2 (p = 0.002), research productivity (p = 0.001) and overall scores (p = 0.02). Use of USMLE cutoff scores demonstrated disparate effects on female and URM candidates.

Objective scoring of applications and use of USMLE cutoff scores can disadvantage candidates from underrepresented groups. Screening filters can affect the diversity of candidate pools for radiology residency.