Urology. 2021 Jun 9:S0090-4295(21)00474-X. doi: 10.1016/j.urology.2021.05.047. Online ahead of print.
OBJECTIVES: To assess a potential source of bias that could contribute to underrepresentation of minorities in urology, we analyzed differences in linguistic characteristics in personal statements between urology residency applicants of various racial and ethnic groups.
METHODS: Personal statements submitted by urology residency applicants to a urology program were evaluated with Linguistic Inquiry and Word Count (LIWC), a validated text analysis program. Analyzed statements and application characteristics were compared according to self-identified race/ethnicity of the applicant using multivariable analysis and independent sample T-tests.
RESULTS: Of 342 submitted personal statements, 181 applicants self-identified as White non-Hispanic, 86 as Asian, and 75 as “underrepresented in medicine” (URM) including Black and Hispanic/Latino applicants. Asian and URM applicants listed more research projects (11.7 and 12.9 vs. 8.8, p=0.01) and URM applicants had slightly lower USMLE Step 1 scores (238.5 vs. 244.6, p=0.01) compared to White applicants. When evaluating personal statements, all applicants wrote with the same degree of analytical thinking. Asian applicants scored lower in authenticity (p=0.03) and emotional tone (p=0.04) while URM applicants scored higher in clout (p=0.04) compared to White applicants. In use of pronouns, Asian applicants used ‘we/us/our’ more often (p<0.01), URM applicants used ‘you’ more often (p=0.02), and White applicants used ‘I’ more often (p=0.01).
CONCLUSIONS: Significant linguistic differences exist among urology personal statements by racial/ethnic groups that may perpetuate stereotypes and bias in the application process. Appreciating these differences may help applicants avoid possibly detrimental linguistics and help residency programs recruit and support urology applicants from underrepresented backgrounds.