Abstract
ObjectiveThe purpose of this study was to determine whether gender influences the likelihood of receiving a lower-third global assessment (GA) on the standardized letter of evaluation (SLOE) submitted as part of the emergency medicine (EM) application process as well as the impact of gender on ultimate match outcomes for applicants receiving a lower-third GA ranking. Our hypothesis was that female applicants with a lower-third GA ranking have a higher risk of not matching.MethodsWe conducted a retrospective cohort study evaluating U.S.-based allopathic applicants to a single EM residency program in the Mid-Atlantic region during the 2017-2018 and 2018-2019 match cycles. GA SLOE rankings and gender for all applicants were extracted and compared to the National Resident Matching Program (NRMP) data for each applicant on match outcome. Comparative analyses were conducted between gender and SLOE GA rankings in order to obtain an odds ratio (OR) of gender and match outcomes.ResultsA total of 2,017 SLOEs were reviewed from 798 applicants in the 2018 and 2019 EM match cycles. Overall, 716 (90%) applicants successfully matched in EM, with 82 (10%) applicants failing to match into EM; 277 students had at least one lower-third GA ranking. For all applicants, having at least one lower-third GA ranking was associated with a significant risk of not matching (OR: 0.20; 95% CI: 0.12-0.34). Of the 277 students with at least one lower-third GA ranking, 85 (31%) were female and 192 (69%) were male. Of the female applicants with a lower-third GA ranking, 15 (18%) failed to match in EM, and 39 (20%) of the males failed to match in EM. For applicants with a lower-third GA ranking, female gender alone was not associated with a significantly increased risk of not matching (OR: 1.18; 95% CI: 0.61-2.21).ConclusionsFemale applicants receive a lower-third GA ranking less frequently than their male counterparts. One or more lower-third rankings on the GA significantly reduced an applicant’s chances of matching into an EM program. For those with a lower-third GA ranking, female gender alone does not significantly increase the risk of not matching into EM.
Highlights
Residency program directors (PDs) in every specialty must filter through large amounts of data points when selecting applicants for residency interviews and making decisions on ranking those applicants
716 (90%) applicants successfully matched in emergency medicine (EM), with 82 (10%) applicants failing to match into EM; 277 students had at least one lower-third global assessment (GA) ranking
For all applicants, having at least one lower-third GA ranking was associated with a significant risk of not matching (OR: 0.20; 95% confidence intervals (CIs): 0.12-0.34)
Summary
Residency program directors (PDs) in every specialty must filter through large amounts of data points when selecting applicants for residency interviews and making decisions on ranking those applicants. In emergency medicine (EM), it is well known that the standardized letter of evaluation (SLOE) serves as one of the most important, if not the most important, parts of the application for PD reference when making these decisions [1,2]. Prior work has repeatedly demonstrated the SLOE to be the primary driver in the application review process. This reputation likely comes from the fact that the SLOE is a standardized template form for evaluation that is easy for authors to complete, provides objective information that is pertinent to EM as a specialty, and is succinct to allow for efficient review by program leaders [2,3]. The SLOE template allows the author to assess an applicant’s performance in a way that can be compared to other EM-bound applicants in a construct that is not onerous for authors to complete and easy for letter readers to review and interpret
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