Gender Biases Persist in Medical Recommendation Letters

Systematic review identifies gender biases in letters of recommendation written for medical residency and academic positions, mirroring findings from other disciplines.

Is gender bias present in letters of reference for medical residency and academia?

Letters of recommendation (LORs) are a method for judging an applicant’s achievements and personal qualities, and are a pivotal element of a residency or job application. Previous research in areas such as psychology and business suggest that LORs are influenced by gender stereotypes and unconscious biases. Women are typically described as being more communal, a term associated with personality traits such as nurturing and kindness, whereas men are described with leadership-oriented personality traits, such as confidence.

To investigate this issue within the medical field, a systematic review was conducted on articles examining gender discrepancies in LORs in the medical community, including medical residency and academic positions. Articles were surveyed from three databases in the fields of biomedical sciences and psychology.

Out of 237 articles initially identified, 16 met the analysis criteria, encompassing 12,738 LORs. They discovered that 64% of the studies found a significant gender difference between the use of communal and leadership-oriented adjectives. Consistent with previous studies, the most common finding was a higher frequency of communal adjectives in LORs written for women, while men were more likely to be described with leadership-oriented adjectives. Furthermore, LORs written for women were more likely to comment on their physical appearance, such as their smile. Women’s LORs were also more likely to reference a her personal life and/or family.

These trends underscore the enduring presence of gender bias, potentially impacting career trajectories for women in medicine. This systematic review underscores the need for heightened awareness and corrective measures to address gender bias in letters of recommendation. Such biases not only perpetuate outdated stereotypes but also have tangible effects on the professional advancement of women in medicine.

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Study Details

Study/Article Type: Systematic Review

Sample size(s): 16 articles that included 12,738 LORs

Participants: N/A

Reference:

Khan, S., Kirubarajan, A., Shamsheri, T., Clayton, A., & Mehta, G. (2023). Gender bias in reference letters for residency and academic medicine: A systematic review. Postgraduate Medical Journal, 99(1170), 272–278. https://doi.org/10.1136/postgradmedj-2021-140045

Summarized by WinSights team member Victoria Hossack

Edited by: Margie Christ, Bilal Rashid