过分强调步骤 1 分数可能会影响放射肿瘤学的申请池多样性。
Overemphasis of Step 1 Scores May Affect Application Pool Diversity in Radiation Oncology.
机构信息
Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania.
Department of Emergency Medicine, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania.
出版信息
Pract Radiat Oncol. 2020 Jan-Feb;10(1):e3-e7. doi: 10.1016/j.prro.2019.07.009. Epub 2019 Jul 29.
PURPOSE
Many radiation oncology programs use Step 1 score metrics as a surrogate for intelligence and success to screen applicants. The impact of this practice on radiation oncology applicant pool diversity is unknown.
METHODS AND MATERIALS
Electronic Residency Application Service applications submitted to our institution between 2015 and 2018 match cycles were reviewed. Sex, age, race/ethnicity, and Step 1 scores were collected. Groupings by characteristics were sex (female vs male), age ≤30 versus >30 years, and race/ethnicity by underrepresented minority (URM) versus non-URM status. URMs were defined as Black/African American, Hispanic, Native American/Alaskan Native, and Hawaiian/Pacific Islander. Step 1 scores were divided based on scores of 220 and 240. The association between applicant demographics and Step 1 scores was assessed using proportional odds logistic regression for ordinal outcomes.
RESULTS
Eight hundred ten applicants with Step 1 scores ranging from 188 to 275 were collected, representing nearly 90% of all applicants during the 2015 to 2018 Electronic Residency Application Service cycles. Twenty-nine percent were female, 29% were >30 years of age, and 10% were URMs. Increasing Step 1 score requirements disproportionately decreased representation of applicants who were female versus male at 240 (-51% vs -31%), >30 versus ≤30 years old at 220 (-28% vs -6%) and 240 (-55% vs -26%), and URMs versus non-URMs at 220 (-34% vs -9%) and 240 (-61% vs -34%). On analysis, Step 1 score requirements had a statistically significantly impact on applicant distributions based on sex, age, and URM status (P < .001).
CONCLUSIONS
Overemphasis of Step 1 scores may reduce the diversity of the radiation oncology applicant pool. Further evaluation of practices that counter the stated American Society of Clinical Oncology, American Society of Radiation Oncology, and American College of Radiology diversity missions should be pursued to improve understanding of barriers and biases.
目的
许多放射肿瘤学项目使用 Step 1 分数作为筛选申请人的智力和成功的替代指标。这种做法对放射肿瘤学申请人群体多样性的影响尚不清楚。
方法与材料
对 2015 年至 2018 年匹配周期内在我院提交电子住院医师申请服务 (Electronic Residency Application Service， ERAS) 申请的申请人进行了审查。收集了申请人的性别、年龄、种族/民族和 Step 1 分数。按特征进行分组的类别为：女性与男性、年龄≤30 岁与>30 岁、代表性不足的少数族裔 (underrepresented minority，URM) 与非 URM。URM 定义为黑人/非裔美国人、西班牙裔、美国原住民/阿拉斯加原住民和夏威夷/太平洋岛民。根据分数 220 和 240 将 Step 1 分数进行了分组。使用有序逻辑回归对 ordinal 结果进行评估，以评估申请人特征与 Step 1 分数之间的关联。
结果
共收集了 810 名 Step 1 分数在 188 至 275 之间的申请人，代表了 2015 年至 2018 年期间 ERAS 周期内几乎 90%的所有申请人。29%为女性，29%年龄>30 岁，10%为 URM。随着 Step 1 分数要求的提高，女性申请人的代表性相对于男性申请人的比例逐渐下降，在 240 分处的降幅为 51%，而在 220 分处的降幅为 31%；在 220 分处的降幅为 28%，而在 240 分处的降幅为 6%；URM 申请人的代表性相对于非 URM 申请人的比例逐渐下降，在 220 分处的降幅为 34%，而在 240 分处的降幅为 9%；在 240 分处的降幅为 61%，而在 240 分处的降幅为 34%。分析结果显示，Step 1 分数要求对基于性别、年龄和 URM 状态的申请人分布具有统计学显著影响 (P<0.001)。
结论
过分强调 Step 1 分数可能会降低放射肿瘤学申请人群体的多样性。应进一步评估旨在实现美国临床肿瘤学会 (American Society of Clinical Oncology，ASCO)、美国放射肿瘤学会 (American Society of Radiation Oncology，ASTRO) 和美国放射学会 (American College of Radiology，ACR) 多样化使命的实践，以增进对障碍和偏见的理解。
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