Eliminating Disparities in Otolaryngology Resident Application Selection.

Area of Science:

• Medical Education
• Surgical Residency Admissions
• Diversity and Inclusion in Medicine

Background:

• Traditional otolaryngology residency selection metrics like USMLE scores and publication counts have historically limited diversity.
• Underrepresentation of marginalized groups, women, and individuals from outside the geographic region persists in otolaryngology training programs.

Purpose of the Study:

• To develop and implement a novel residency application review process designed to mitigate bias.
• To increase the diversity of interviewed and matched residents in an otolaryngology program.

Main Methods:

• A standardized rubric was created, de-emphasizing USMLE scores, honor societies, and publication numbers.
• An AI-driven pre-sort facilitated a holistic review, prioritizing personal statements, life experiences, community achievements, leadership, and letters of recommendation.
• Applicant demographics were compared pre- and post-implementation.

Main Results:

• The otolaryngology program saw significant diversification in its resident cohort between 2019 and 2022.
• The percentage of historically marginalized residents increased from 4% to 24%.
• Female resident representation rose from 28% to 44%, and residents from outside the geographic region increased from 33% to 66%.

Conclusions:

• Holistic review processes can effectively increase diversity in otolaryngology residency selection.
• De-emphasizing traditional metrics like USMLE Step 1 scores is crucial for fostering a more inclusive training environment.
• Purposeful changes in application review can lead to a more diverse and representative resident cohort.