Medical school admission committee members' evaluations of and impressions from recommendation letters

Gender-based differences in letters of recommendation written for ophthalmology residency applicants

BACKGROUND

To determine whether gender-based differences may be present in letters of recommendation written for ophthalmology residency applicants.

METHODS

All applications submitted through SF Match to the UCLA Stein Eye Institute Residency Training Program from the 2017-2018 application cycle were analyzed using validated text analysis software (Linguistic Inquiry and Word Count (Austin, TX)). The main outcome measures were differences in language use in letters of recommendation by gender of applicant.

RESULTS

Of 440 applicants, 254 (58%) were male and 186 (42%) were female. The two gender groups had similar United States Medical Licensing Exam (USMLE) Step 1 scores, undergraduate grade point averages (uGPA's), proportions of underrepresented minority (URM) applicants and Gold Humanism Honor Society members, numbers of academic and service activities listed, and gender distributions of their letter writers (all P values > 0.05). However, letters written for male applicants were determined to use more "authentic" words than those written for female applicants (mean difference, 0.800; 95% CI, 0.001-1.590; P = 0.047). Letters written for male applicants also contained more "leisure" words (mean difference, 0.056; 95% CI, 0.008-0.104; P = 0.023) and fewer "feel" words (mean difference, 0.033; 95% CI, 0.001-0.065; P = 0.041) and "biological processes" words (mean difference, 0.157; 95% CI, 0.017-0.297; P = 0.028).

CONCLUSIONS

There were gender differences detected in recommendation letters in ophthalmology consistent with prior studies from other fields. Awareness of these differences may improve residency selection processes.

The Intentions of Letter Writers for Applicants to a Baccalaureate-M.D. Program: Self-Report and Content Analyses of Letters of Reference

BACKGROUND

The purpose of this study was to determine how individuals providing reference letters framed the task and the specific attributes used to describe applicants.

METHODS

Participants were letter writers (N=106) for accepted or alternate applicants. Participants received a brief anonymous survey and a return postcard to release their past letter for content analysis.

RESULTS

Seventy-six percent of letter writers (N=81) returned a survey. Most (64%) intended to describe applicants' positive accomplishments. According to respondents' they were most likely to write about academic accomplishments (85%), work ethic (78%), dependability (70%) and motivation (70%). Seventy-four respondents (70%) released their letter for content analysis. Academic accomplishments (77%), motivation (41%) and leadership (41%) were the attributes most frequently mentioned in the letters.

CONCLUSIONS

Most letter writers see their role as supportive rather than evaluative. Academic accomplishments, though often mentioned, are available from other sources. Many non-cognitive attributes of most interest to admissions committees are least likely to appear in reference letters.

Emergency medicine standardized letter of recommendation: predictors of guaranteed match

OBJECTIVE

The Council of Emergency Medicine Residency Directors (CORD) standardized letter of recommendation (SLOR) has become a common, reliable, and useful tool in the evaluation of emergency medicine (EM) applicants. A "guaranteed match" (GM) is the SLOR's bottom-line superlative response. It is also the SLOR's least common superlative response. Because candidates receiving a GM are a select group, the authors thought it would be useful to identify SLOR information that predicts a GM recommendation.

METHODS

This was a secondary analysis of a database of all EM SLORs submitted to a single EM residency during the 1998--1999 application cycle to one EM residency program. Response to GM and 16 data points in the background/qualification sections were analyzed by chi-square, univariate analysis, and logistic regression.

RESULTS

Four hundred eleven SLORs were analyzed. Qualification information was more predictive than background information for applicants receiving a GM. The highest univariate odds ratios for background information were "staff author" (OR = 1.7, 1.0--2.8), "extended contact" (OR = 2.2, 1.0--4.5), "clinical contact outside the ED" (OR = 3.0, 1.5--5.9), and "honors on EM rotation" (OR = 5.4, 3.0--9.8). The highest univariate odds ratios for qualification information were "outstanding differential diagnosis ability" (OR = 10.1, 5.8--17.4), "outstanding work ethic" (OR = 13.1, 5.2--33.3), and "outstanding global assessment" (OR = 58, 24.2--139). Logistic regression analysis demonstrated "outstanding global assessment" (p < 0.000; r = 0.92) and "outstanding work ethic" (p = 0.028; r = 0.71) to be statistically predictive of GM.

CONCLUSIONS

There were both background and qualification data points predictive of a "guaranteed match." Qualification information had a greater predictive value than background information. Medical student applicants, letter writers, and letter evaluators may find this information useful when dealing with SLORS.

A standardized letter of recommendation for residency application

Emergency medicine (EM) program directors have expressed a desire for more evaluative data to be included in application materials. This is consistent with frustrations expressed by program directors of multiple specialties, but mostly by those in specialties with more competitive matches. Some of the concerns about traditional narrative letters of recommendation included lack of uniform information, lack of relative value given for interval grading, and a perception of ambiguity with regard to terminology. The Council of Emergency Medicine Residency Directors established a task force in 1995 that created a standardized letter of recommendation form. This form, to be completed by EM faculty, requests that objective, comparative, and narrative information be reported regarding the residency applicant.