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Race and Gender Bias in Narrative Letters of Recommendation for Plastic Surgery Residency Applicants.

Publication ,  Journal Article
Yi, VN; Seo, JE; McDowell, C; Phillips, BT; Rezak, K; Allori, AC; Patel, A
Published in: J Surg Res
January 7, 2025

INTRODUCTION: It has been previously shown that gender bias exists in standardized letters of recommendation for plastic surgery residency. However, similar analysis has not been conducted for narrative letters of recommendation (NLORs). Therefore, this study aims to determine if there exists linguistic bias in NLORs for plastic surgery residency based on applicants' and writers' gender and race. METHODS: The sample included applicants to a 6-y integrated plastic surgery residency program within application cycles from 2021 to 2023. The exclusion criteria included reapplicants and applicants without NLORs. Applicant demographics were self-identified. Faculty gender was identified through public online platforms and faculty race through Namsor, validated artificial intelligence software for name classification. The Linguistic Inquiry and Word Count program was used to calculate the amount of words in each NLOR that fell within predetermined linguistic categories, such as power and social behavior. Descriptive statistics and Wilcoxon rank-sum tests were used in the analysis were appropriate. RESULTS: Six hundred twenty-six unique applicants had at least one NLOR. Female writers used more descriptive evaluations of applicants compared to male writers with greater emphasis on applicants' social and emotional qualities. White writers used more words conveying negative tone to describe non-White applicants. Non-White writers used more word describing accomplishment, drive, and social qualities of non-White applicants compared to White Applicants. CONCLUSIONS: Analysis of NLORs revealed differences related to gender and race. Female writers produced more favorable recommendations than male writers. Racial discordance between writer and applicant resulted in differences in the letter quality. Faculty education to improve the objectivity of NLORs is necessary.

Duke Scholars

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

January 7, 2025

Volume

306

Start / End Page

152 / 164

Location

United States

Related Subject Headings

  • Surgery
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Yi, V. N., Seo, J. E., McDowell, C., Phillips, B. T., Rezak, K., Allori, A. C., & Patel, A. (2025). Race and Gender Bias in Narrative Letters of Recommendation for Plastic Surgery Residency Applicants. J Surg Res, 306, 152–164. https://doi.org/10.1016/j.jss.2024.12.017
Yi, Victoria N., J Eleanor Seo, Colleen McDowell, Brett T. Phillips, Kristen Rezak, Alexander C. Allori, and Ash Patel. “Race and Gender Bias in Narrative Letters of Recommendation for Plastic Surgery Residency Applicants.J Surg Res 306 (January 7, 2025): 152–64. https://doi.org/10.1016/j.jss.2024.12.017.
Yi VN, Seo JE, McDowell C, Phillips BT, Rezak K, Allori AC, et al. Race and Gender Bias in Narrative Letters of Recommendation for Plastic Surgery Residency Applicants. J Surg Res. 2025 Jan 7;306:152–64.
Yi, Victoria N., et al. “Race and Gender Bias in Narrative Letters of Recommendation for Plastic Surgery Residency Applicants.J Surg Res, vol. 306, Jan. 2025, pp. 152–64. Pubmed, doi:10.1016/j.jss.2024.12.017.
Yi VN, Seo JE, McDowell C, Phillips BT, Rezak K, Allori AC, Patel A. Race and Gender Bias in Narrative Letters of Recommendation for Plastic Surgery Residency Applicants. J Surg Res. 2025 Jan 7;306:152–164.
Journal cover image

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

January 7, 2025

Volume

306

Start / End Page

152 / 164

Location

United States

Related Subject Headings

  • Surgery
  • 3202 Clinical sciences
  • 1103 Clinical Sciences