Abstract
IntroductionPrior research demonstrates gender differences in language used in letters of recommendation. The emergency medicine (EM) Standardized Letter of Evaluation (SLOE) format limits word count and provides detailed instructions for writers. The objective of this study is to examine differences in language used to describe men and women applicants within the SLOE narrative.MethodsAll applicants to a four-year academic EM residency program within a single application year with a first rotation SLOE available were included in the sample. We used the Linguistic Inquiry and Word Count (LIWC) program to analyze word frequency within 16 categories. Descriptive statistics, chi-squared, and t-tests were used to describe the sample; gender differences in word frequency were tested for using Mann-Whitney U tests.ResultsOf 1117 applicants to the residency program, 822 (82%) first-rotation SLOEs were available; 64% were men, and 36% were women. We did not find a difference in baseline characteristics including age (mean 27 years), top 25 schools (22.5%), Alpha Omega Alpha Honor Medical Society rates (13%), and having earned advanced degrees (10%). The median word count per SLOE narrative for men was 171 and for women was 180 (p = 0.15). After adjusting for letter length, word frequency differences between genders were only present in two categories: social words (women: 23 words/letter; men: 21 words/letter, p = 0.02) and ability words (women: 2 words/letter; men: 1 word/letter, p = 0.04). We were unable to detect a statistical difference between men and women applicants in the remaining categories, including words representing communal traits, agentic traits, standout adjectives, grindstone traits, teaching words, and research words.ConclusionThe small wording differences between genders noted in two categories were statistically significant, but of unclear real-world significance. Future work is planned to evaluate how the SLOE format may contribute to this relative lack of bias compared to other fields and formats.
Highlights
Prior research demonstrates gender differences in language used in letters of recommendation
After adjusting for letter length, word frequency differences between genders were only present in two categories: social words and ability words
Future work is planned to evaluate how the Standardized Letter of Evaluation (SLOE) format may contribute to this relative lack of bias compared to other fields and formats. [West J Emerg Med. 2019;20(6)948-956.]
Summary
Prior research demonstrates gender differences in language used in letters of recommendation. Women in academic medicine are less likely to achieve the rank of professor or hold senior leadership positions compared to men, even after adjusting for age, experience, specialty, and research productivity.[1,2] Previous studies in other professional fields have shown that there are differences in language used in describing men and women in letters of recommendation.[3,4,5] Additional studies have shown that evaluations of women medical students are more likely to describe women as “caring,” “compassionate,”. Standardized Letter of Evaluation: Differences in Language by Gender and “empathetic,” in addition to “bright” and “organized,” than male medical students.[6,7,8] In addition, women are more often portrayed as teachers and students, and less often portrayed as researchers or professionals compared to men.[9]. The SLOE contains both a quantitative evaluation of an applicant and a narrative portion of 250 words or less.[12,13,14] The SLOE narrative provides a focused assessment of the noncognitive attributes of potential residency candidates.[15]
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