Gender-based differences in letters of recommendation in applications for general surgery residency programs in Canada

Jennifer Koichopolos; Michael C. Ott; Allison H. Maciver; Julie Ann M. Van Koughnett

doi:10.1503/cjs.025120

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Fig. 1
Proportion of letters of recommendation written by male and female writers based on the gender of the applicant.

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Table 1

Frequency of descriptors in letters of reference

Descriptor	No. (%) of letters containing descriptor		p value
Descriptor	Female applicants n = 126	Male applicants n = 89	p value
Knowledge	104 (82.5)	74 (83.1)	0.7
Intelligence	29 (23.0)	24 (27.0)	0.5
Interest	75 (59.5)	56 (62.9)	0.6
Natural ability or intuitiveness	17 (13.5)	9 (10.1)	0.5
Preparedness	33 (26.2)	30 (33.7)	0.2
Functioned like a resident	53 (42.1)	39 (43.8)	0.8
Clinical skills	78 (61.9)	52 (58.4)	0.6
Clinical notes	19 (15.1)	18 (20.2)	0.3
Efficient	29 (23.0)	16 (18.0)	0.4
Initiative	36 (28.6)	14 (15.7)	0.03
Responsive to feedback	14 (11.1)	7 (7.9)	0.4
Dedicated to specialty	58 (46.0)	44 (49.4)	0.6
Hard working or dedicated	88 (69.8)	61 (68.5)	0.8
Self-sacrificing	33 (26.2)	32 (36.0)	0.1
Sense of responsibility	31 (24.6)	25 (28.1)	0.6
Mature	38 (30.2)	14 (15.7)	0.02
Technical skills	89 (70.6)	68 (76.4)	0.3
Teamwork	77 (61.1)	64 (71.9)	0.1
Integration (“fit in”)	28 (22.2)	19 (21.3)	0.9
Professional	35 (27.8)	25 (28.1)	1.0
Judgment	49 (38.9)	42 (47.2)	0.2
Pleasant or positive disposition	55 (43.7)	24 (27.0)	0.01
Knew their limitations	9 (7.1)	5 (5.6)	0.6
Young man or woman	10 (7.9)	10 (11.2)	0.4
Appearance or smile	5 (4.0)	2 (2.2)	0.5
Quiet, shy, understated or reserved	13 (10.3)	10 (11.2)	0.8
Humble	4 (3.2)	4 (4.5)	0.6
Enthusiasm	30 (23.8)	21 (23.6)	0.7
Polite or respectful	16 (12.7)	17 (19.1)	0.2
Flexible	8 (6.3)	0 (0.0)	0.02
Attitude	28 (22.2)	15 (16.9)	0.3
Communication	54 (42.9)	37 (41.6)	0.9
Research and awards	53 (42.1)	51 (57.3)	0.03
Desire to have in training program	56 (44.4)	38 (42.7)	0.8
Kind or compassionate	25 (19.8)	12 (13.5)	0.2
Confident	14 (11.1)	4 (4.5)	0.08
Comparison to others	98 (77.8)	72 (80.9)	0.6
Good future resident	55 (43.7)	30 (33.7)	0.1
Good future surgeon	36 (28.6)	28 (31.5)	0.6
Extracurricular or “well rounded”	12 (9.5)	21 (23.6)	0.005
Personal facts	11 (8.7)	14 (15.7)	0.1
Good assistant	22 (17.5)	16 (18.0)	0.9
Patient-centred care	17 (13.5)	8 (9.0)	0.3
Leadership	21 (16.7)	14 (15.7)	0.8
Teachable	16 (12.7)	8 (9.0)	0.4

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Table 2

Phrases identified in reference letters to general surgery based on gender of applicant^*

Rank	Female applicant			Male applicant

	Phrase	Frequency	Proportion of letter’s words, %	Phrase	Frequency	Proportion of letter’s words, %
1	Technical skills	44	1.61	Knowledge base	31	1.61

2	Junior resident	38	1.39	Technical skills	31	1.61

3	Knowledge base	38	1.39	Work ethic	31	1.61

4	Work ethic	38	1.39	Communication skills	21	1.09

5	Hard working	34	1.24	Junior resident	20	1.04

6	Above average	31	1.14	Cognitive skills	16	0.83

7	Communication skills	29	1.06	Patient care	15	0.78

8	Pleasure to work	23	0.84	Research projects	15	0.78

9	Patient care	21	0.77	Above average	13	0.68

10	Support of application	20	0.73	Problem solving	13	0.68

↵* The frequency is the number of times this phrase occurred in a combined document of all female or male applicant letters. The proportion of the letter’s words shows the percentage of the total words in the combined document of all female or male applicant letters that are the phrase words.