Ethnic and Racial Differences in Ratings in the Medical Student Standardized Letters of Evaluation (SLOE)

Author:

Alvarez Al'ai1ORCID,Mannix Alexandra2,Davenport Dayle3,Gore Katarzyna4,Krzyzaniak Sara M.5,Parsons Melissa6,Miller Danielle T.7ORCID,Eraso Daniel8,Monteiro Sandra9ORCID,Chan Teresa M.10ORCID,Gottlieb Michael11ORCID

Affiliation:

1. Al'ai Alvarez, MD, is Clinical Associate Professor and Director of Well-Being, Department of Emergency Medicine, Stanford University

2. Alexandra Mannix, MD, is Assistant Professor and Assistant Program Director, Department of Emergency Medicine, University of Florida College of Medicine–Jacksonville

3. Dayle Davenport, MD, is Associate Professor, Department of Emergency Medicine, Rush University Medical Center and Assistant Dean, Diversity and Inclusion, Rush Medical College

4. Katarzyna Gore, MD, is Associate Professor and Assistant Program Director, Department of Emergency Medicine, Rush University Medical Center

5. Sara M. Krzyzaniak, MD, is Clinical Associate Professor and Program Director, Department of Emergency Medicine, Stanford University

6. Melissa Parsons, MD, is Associate Professor and Assistant Program Director, Department of Emergency Medicine, University of Florida College of Medicine–Jacksonville

7. Danielle T. Miller, MD, MEd, is Assistant Professor, Department of Emergency Medicine, University of Colorado School of Medicine

8. Daniel Eraso, MD, is Assistant Professor, Department of Emergency Medicine, University of Florida College of Medicine–Jacksonville

9. Sandra Monteiro, PhD, is Associate Professor, Department of Medicine, McMaster University, Ontario, Canada

10. Teresa M. Chan, MD, MHPE, is Associate Professor, Department of Medicine (Division of Emergency Medicine; Division of Education & Innovation), and Associate Dean, Continuing Professional Development, Faculty of Health Sciences, McMaster University, Ontario, Canada

11. Michael Gottlieb, MD, is Associate Professor and Ultrasound Director, Department of Emergency Medicine, Rush University Medical Center

Abstract

ABSTRACT Background The Standardized Letter of Evaluation (SLOE) stratifies the assessment of emergency medicine (EM) bound medical applicants. However, bias in SLOE, particularly regarding race and ethnicity, is an underexplored area. Objective This study aims to assess whether underrepresented in medicine (UIM) and non-UIM applicants are rated differently in SLOE components. Methods This was a cross-section study of EM-bound applicants across 3 geographically distinct US training programs during the 2019-2020 application cycle. Using descriptive and regression analyses, we examine the differences between UIM applicants and non-UIM applicants for each of the SLOE components: 7 qualifications of an EM physician (7QEM), global assessment (GA) rating, and projected rank list (RL) position. Results Out of a combined total of 3759, 2002 (53.3%) unique EM-bound applicants were included. UIM applicants had lower ratings for each of the 7QEM questions, GA, and RL positions. Compared to non-UIM applicants, only some of the 7QEM components: “Work ethic and ability to assume responsibility,” “Ability to work in a team, and “Ability to communicate a caring nature,” were associated with their SLOE. “Commitment to EM” correlated more with GA for UIM than for non-UIM applicants. Conclusions This study shows a difference in SLOE rating, with UIM applicants receiving lower ratings than non-UIM applicants.

Publisher

Journal of Graduate Medical Education

Subject

General Medicine,Education

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