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Avoiding Gender Bias Using A Gender Neutral Scoring System: The Case Western Plastic Surgery Resident Application Assessment

Katherine A. Grunzweig, MD, Sven Gunther, MD, Lisa DiNardo, PhD, Edward H. Davidson, MD, Ali Totonchi, MD, Anand Kumar, MD
University Hospitals Cleveland Medical Center
2020-01-27

Presenter: Katherine A Grunzweig

Affidavit:
This project has been presented at the local NESPS meeting in 2019, as well as accepted for future presentation at the ACAPS meeting in 2020. The project is predominantly original work in conception by the first author, and carried out by the residents.

Director Name: Anand Kumar

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Purpose: The effects of gender bias during the plastic surgery residency application process remains understudied. We hypothesized using our objective merit-based algorithm, the Case Western Resident Application Assessment (CWRAA), would result in a gender distribution of interviewees proportional to the applicant pool.

Methods: A retrospective study was conducted using the CWRAA, a tool utilizing a tripartite weighted system evaluating Step 1 scores, research, and academic achievements. Data over 5 years was assessed for gender, interviews, ranking, and matching with our institution. Welch two sample t-tests were used to assess scores, and the chi-squared test was used to assess gender proportions. Effect size was assessed using means and pooled standard deviations.

Results: Over 5 years, 829 applicants, 61.9% male, applied to the residency. Average CWRAA score for all applicants was 6.68/15 with no significant difference in means between genders (p=0.62). Average scores and gender proportions of those offered interviews were not significantly different (p=0.13, p=0.69). Amongst interviewees, there was no difference in scores or gender proportions (p=0.77, p=0.87). Ranked applicants had no difference in scores or proportions (p=0.3, p=0.94). The proportion of female residents who matched out of the female pool, compared to males, was significant (p=0.049). Scores were not significantly different (p=0.76).

Conclusions: The CWRAA score system is an objective ranking mechanism of applicants based on multiple non-gender specific metrics. Using an objective metric to filter applicants does not result in unequal gender proportions, suggesting an objective merit-based algorithm helps avoid gender bias in the application process.

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