Does Racial Bias Play a Role in Internal Medicine Resident Knowledge Evaluations?
Authors: Andrea Anderson, Chavon Onumah
Journal: Annals of Internal Medicine (2023)

Editorials26 December 2023Does Racial Bias Play a Role in Internal Medicine Resident Knowledge Evaluations?Andrea Anderson, MD, MEd, Chavon Onumah, MD, MEd, MPHAndrea Anderson, MD, MEdDepartment of Emergency Medicine, Division of Family Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, Chavon Onumah, MD, MEd, MPHDepartment of Internal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DCAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-3141 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail We read with interest Gray and colleagues’ attempt to quantify how the 2014 adoption of the Milestone ratings system may have influenced evaluation bias against minoritized groups in graduate medical education (GME) (1). As undergraduate and graduate medical educators and as prior (A.A.) and current (C.O.) GME program leaders at major U.S. medical schools, we applaud this effort. Evaluation or assessment bias is difficult to identify, assess, and systematically confront. Bias in assessment has been documented and has negative implications for learners from groups that have historically been underrepresented in medicine (URiM), the health care system, and health equity goals ...References1. Gray BM, Lipner RS, Roswell RO, et al. Adoption of internal medicine milestone ratings and changes in bias against Black, Latino, and Asian internal medicine residents. Ann Intern Med. 26 December 2023. [Epub ahead of print]. doi:10.7326/M23-1588 LinkGoogle Scholar2. Lucey CR, Hauer KE, Boatright D, et al. Medical education's wicked problem: achieving equity in assessment for medical learners. Acad Med. 2020;95:S98-S108. [PMID: 32889943] doi:10.1097/ACM.0000000000003717 CrossrefMedlineGoogle Scholar3. Teherani A, Hauer KE, Fernandez A, et al. How small differences in assessed clinical performance amplify to large differences in grades and awards: a cascade with serious consequences for students underrepresented in medicine. Acad Med. 2018;93:1286-1292. [PMID: 29923892] doi:10.1097/ACM.0000000000002323 CrossrefMedlineGoogle Scholar4. Boatright D, Anderson N, Kim JG, et al. Racial and ethnic differences in internal medicine residency assessments. JAMA Netw Open. 2022;5:e2247649. [PMID: 36580337] doi:10.1001/jamanetworkopen.2022.47649 CrossrefMedlineGoogle Scholar5. Klein R, Ufere NN, Schaeffer S, et al. Association between resident race and ethnicity and clinical performance assessment scores in graduate medical education. Acad Med. 2022;97:1351-1359. [PMID: 35583954] doi:10.1097/ACM.0000000000004743 CrossrefMedlineGoogle Scholar6. Ellis J, Otugo O, Landry A, et al. Dismantling the overpolicing of Black residents. N Engl J Med. 2023;389:1258-1261. [PMID: 37782019] doi:10.1056/NEJMp2304559 CrossrefMedlineGoogle Scholar7. Gonzaga AMR, Appiah-Pippim J, Onumah CM, et al. A framework for inclusive graduate medical education recruitment strategies: meeting the ACGME standard for a diverse and inclusive workforce. Acad Med. 2020;95:710-716. [PMID: 31702694] doi:10.1097/ACM.0000000000003073 CrossrefMedlineGoogle Scholar8. Hauer KE, Park YS, Bullock JL, et al. “My assessments are biased!” measurement and sociocultural approaches to achieve fairness in assessment in medical education. Acad Med. 2023. [PMID: 37094278] doi:10.1097/ACM.0000000000005245 CrossrefMedlineGoogle Scholar9. Onumah CM, Pincavage AT, Lai CJ, et al. Strategies for advancing equity in frontline clinical assessment. Acad Med. 2023. [PMID: 37071692] doi:10.1097/ACM.0000000000005246 CrossrefMedlineGoogle Scholar10. Teherani A, Perez S, Muller-Juge V, et al. A narrative study of equity in clinical assessment through the antideficit lens. Acad Med. 2020;95:S121-S130. [PMID: 33229956] doi:10.1097/ACM.0000000000003690 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Andrea Anderson, MD, MEd; Chavon Onumah, MD, MEd, MPHAffiliations: Department of Emergency Medicine, Division of Family Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DCDepartment of Internal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DCDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-3141.Corresponding Author: Andrea Anderson, MD, MEd, Associate Professor, Department of Emergency Medicine, Division of Family Medicine, The George Washington University School of Medicine and Health Sciences, 2120 L Street NW, Suite 402, Washington, DC 20037; e-mail, aanderson3125@gwu.edu.This article was published at Annals.org on 26 December 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAdoption of Internal Medicine Milestone Ratings and Changes in Bias Against Black, Latino, and Asian Internal Medicine Residents Bradley M. Gray , Rebecca S. Lipner , Robert O. Roswell , Alicia Fernandez , Jonathan L. Vandergrift , and Marcella Alsan Metrics Latest Keywords Graduate medical education Health disparities Health equity Medical education Racial and ethnic issues Residency ePublished: 26 December 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...