26. Gender Differences in Cardiothoracic Surgery Letters of Recommendation
University of Michigan Medical Center
Ann Arbor, MI
United States - Contact Me
Rishindra M. Reddy, M.D., M.B.A. earned his undergraduate and medical degrees at Northwestern University, and completed his general surgery residency at Washington University-Barnes Jewish Hospital in St. Louis, Missouri. His spent two years during his residency, as a Clinical Research Fellow at the National Cancer Institute. He completed his Thoracic Surgery residency at the University of Washington and was a visiting fellow at Memorial Sloan Kettering Cancer Center. He is the endowed Jose Jose Alvarez Professor of Thoracic Oncology Research and is the Chair of the University of Michigan Comprehensive Robotic Surgery Program. Dr. Reddy's clinical interests include all aspects of general thoracic surgery including thoracic oncology, minimally invasive techniques, and therapy for end-stage lung disease including transplantation and lung volume reduction surgery. His academic interests include improving outcomes for patients with thoracic cancers, molecular targeting for thoracic cancers, and resident/medical student education.
Temple University Hospital
Philadelphia, PA
United States - Contact Me
Dr. Valeda Yong is currently a clinical PGY-3 general surgery resident at Temple University Hospital. She completed two professional development years under the mentorship of Dr. Cherie Erkmen at Temple University Hospital and also obtained a MSEd in Professional Health Education at this time. Her research interests lie in surgical education and simulation, as well as disparities in cardiothoracic surgery. She received her MD at Case Western Reserve University School of Medicine and BA in Psychology at Rice University.
Abstract
Methods: From applications to an accredited cardiothoracic surgery fellowship program between 2016 and 2021, applicant and author characteristics were examined with descriptive statistics, analysis of variance, and Pearson-Chi square tests. Letters of recommendation were assessed using linguistic analysis software for differences in communication with respect to author and applicant gender, with higher-level analysis through a Generalized Estimating Equations model of linguistic differences among author-applicant gender pairs.
Results: 739 recommendation letters extracted from 196 applications of individuals were analyzed; 90% (n=665) of authors were male and 55.8% (n=412) of authors were cardiothoracic surgeons. Compared to female authors, male authors wrote more informal (p=0.03) and authentic (p=0.01) recommendation letters. When writing for female applicants, male-authored letters were more likely to display their own leadership and status (p=0.03) and discuss female applicants' social affiliations (p=0.01), like occupation of applicant's father or husband. In contrast, male authors emphasized male applicants' technical abilities (p=0.01). Female authors wrote longer letters (p=0.03) and discussed applicants' work (p=0.01) more often than male authors. They also mentioned leisure activities (p=0.03) more often when writing for female applicants.
Conclusions: Our work identifies gender-specific differences in letters of recommendation. Female applicants are potentially disadvantaged because their recommendation letters are significantly more likely to focus on their social ties, leisure activities, and the status of the letter-writer, while recommendation letters of male colleagues focus on technical skill. Our study identifies an opportunity for individual authors of recommendation letters, applicant review committees, and our professional societies to mitigate gender bias in the selection of candidates to cardiothoracic surgery.