Race, Gender, Sexuality, and the Match: A Trainee's Call to Diversify the Electronic Residency Application Service Statistics.

Abstract

To the Editor: Since 2017, the Association of American Medical Colleges has published Electronic Residency Application Service (ERAS) data on residency applicants’ sex and self-identified race/ethnicity by specialty. 1 These reports inform learners, administrators, policymakers, and the public on the current state of diversity in medical education. Currently, there is no standardized report on sexual orientation, gender identity, or preferred pronouns within ERAS. 1 Additionally, there is no capacity to evaluate the influence of combinatorial gender and racial minority status. The availability of bivariate data reports on medical school applicants elucidated a large disparity in the rates of Black male to female applicant ratios. 2 This disparity could not be recognized if the bivariate analysis of combinatorial race/ethnicity and sex data was not available. Without similar data being made available for ERAS, the potential effect of gender and racial/ethnic minority status on residency applicants remains a mystery. Currently, disparities in health care for gender and sexual minorities remains a pressing topic. 3 However, most application services and diversity reports fail to recognize these variables as elements of diversity. The importance of physicians being representative of the population remains true for gender and sexual minorities. ERAS remains the primary means of tracking diversity variables throughout the residency application process. Among residency program directors, ERAS data was shown to significantly improve residency interviewee diversity across application cycles. 4 Furthermore, within the literature, ERAS data has become a primary means of analyzing trends in gender and race/ethnic diversity across specialties. 5 For these reasons, I propose adding combinatorial race/ethnic and sex data variables, as well as sexual orientation and gender identity, to ERAS as a primary catalyst in diversifying the residency application process.