Trust Me, I Know Them: Assessing Interpersonal Bias in Surgery Residency Interviews

Abstract

Background: Residency selection integrates objective and subjective data sources. Interviews help assess characteristics like insight and communication but have the potential for bias. Structured multiple mini-interviews may mitigate some elements of bias; however, a halo effect is described in assessments of medical trainees, and degree of familiarity with applicants may remain a source of bias in interviews.

Objective: To investigate the extent of interviewer bias that results from pre-interview knowledge of the applicant by comparing file review and interview scores for known versus unknown applicants.

Methods: File review and interview scores of applicants to the University of Ottawa General Surgery Residency Training Program from 2019 to 2021 were gathered retrospectively. Applicants were categorized as "home" if from the institution, "known" if they completed an elective at the institution, or "unknown." The Kruskal-Wallis H test was used to compare median interview scores between groups and Spearman's rank-order correlation (r_s) to determine the correlation between file review and interview scores.

Results: Over a 3-year period, 169 applicants were interviewed; 62% were unknown, 31% were known, and 6% were home applicants. There was a statistically significant difference (P=.01) between the median interview scores of home, known, and unknown applicants. Comparison of groups demonstrated higher positive correlations between file review and interview scores (r_s=0.15 vs 0.36 vs 0.55 in unknown, known, and home applicants) with increasing applicant familiarity.

Conclusions: There is an increased positive correlation between file review and interview scores with applicant familiarity. The interview process may carry inherent bias insufficiently mitigated by the current structure.