The effect of demographic characteristics, Country of birth and country of medical training on the peer evaluations of internal medicine resident physicians

Background: Peer review by resident physicians, a standard evaluation technique, has rarely been studied for potential biases related to demographic and cultural characteristics of trainees. Objective: The study sought to determine whether peer evaluations were favorably biased toward trainees of similar background. Methods: This observational study was conducted in the Internal Medicine residency of a large, metropolitan, community hospital, and included all 91 Internal Medicine residents who had entered the program from 1 July 2009 thru 30 June 2017. Of 3,445 Peer Evaluation Forms (PEF)s offered, 2,922 (84%) were completed and studied. Multivariate statistical analysis was completed. The primary dependent variable was the Peer Evaluation Score (PES). Independent variables included age, gender, race, birth country and country of medical school training. Confounding variables included United States Medical Licensing Examination (USMLE) and In-Training Examination (ITE) scores, and the American Board of Internal Medicine (ABIM) yearly assessment. Results: Confounding factors accounted for most of the variation. Among the independent variables, only age difference and medical school country were statistically associated with PES. Race and Gender were not significant. Conclusions: Peer evaluations were not significantly biased by race or gender similarities and only minimally biased by age and medical school country similarities.

Corema album: unbiased dioecy in a competitive environment

Corema album is a dioecious coastal shrub. Dioecious plants growing in these resource-limited habitats may present spatial segregation of the sexes (SSS) or demographic biases because of the different reproductive effort between sexes. In these environments facilitation is a more common interaction between plants than competition. To assess factors determining the distribution of C. album male and female plants, we investigated the influence of habitat type (sand dunes and coastal woodlands), assessed the occurrence of SSS or demographic biases and also a possible role of these shrubs as nurse plants. We selected three C. album populations with the two habitat types. All C. album individuals were sexed, mapped and measured in three plots (20 m × 20 m) per population/habitat type. Presence and abundance of all plant species were recorded under five female and five male C. album plants as well as in equivalent open ground area in each of 15 plots. According to Ripley's K function result, C. album did not display SSS. Generalised linear mixed models (GLMM) show that differences in plant size were not related to plant sex. Plant inventory correspondence analysis showed that species composition and abundance were influenced by habitat type, population and the presence of a C. album individual, but not by its sex. GLMM indicated a detrimental effect of C. album on the co-occurring plants. Our results show that sexual dimorphism has allowed C. album to adapt to the environment avoiding SSS or significant demographic bias, suggesting a positive outlook for its conservation.