June 7, 2019

Want to land a top residency? Your looks may matter more than your grades.

Daily Briefing

    Editor's note: This popular story from the Daily Briefing's archives was republished on Feb. 10, 2020.

    Medical students' facial attractiveness might affect their chances of landing a residency slot in radiology programs, even more so than their grades, class standing, and extracurricular activities, according to a study published in Academic Medicine

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    Do looks matter in medicine?

    Appearance-based discrimination is common in many fields, but according to Charles Maxfield, vice chair of education at Duke Radiology, appearance-based bias should have no place in the medical field.

    To determine whether medical residency programs discriminate against applicants who are facially unattractive, researchers at Duke University created 76 fake residency candidate profiles and submitted the applications to 74 reviewers for the radiology programs at Duke, Stanford University, Indiana University, Mayo Clinic, and the University of New Mexico.

    The researchers randomly assigned names and demographic information to the applications, as well as pictures that represented a "pre-specified distribution of facial attractiveness and obesity," according to a Duke University release. The researchers also randomly assigned other factors—including class rank, grades, and test scores—to each application.

    According to the release, reviewers thought they were assessing real residency program candidates.

    Facial attractiveness is a strong predictor for medical students' success

    The researchers found that the fake applicants' facial attractiveness strongly predicted whether they would be selected for an interview to get into the medical residency programs.

    In fact, the study found facial attractiveness was a stronger predictor of a positive rating than an applicant's individual race/ethnicity, class rank, clerkship grades, or perceived weight. According to the researchers, applicants who were obese and facially unattractive were half as likely to receive an interview as other applicants.

    However, the researchers noted that the strongest predictor of an applicant's reviewer score was their United States Medical Licensing Examination score.

    Results are 'unfortunate' and 'unjustified,' researchers say

    Maxfield, the lead author of the study, said the findings are "unfortunate and potentially could keep some of … the best potential doctors out of the field."

    Maxfield also said the results were surprising, adding that there is no explanation for the findings. "In the business world there are studies that more attractive people are actually more successful … but in higher education or in medical school there's really no justification for it," he said.

    Maxfield said he believes the findings would not be limited to radiology resident selection. However, he said removing the photograph requirement from residency applications likely not would eliminate the bias, because applicants still would have to attend in-person interviews. Instead, Maxfield said, "Admissions decisions-makers throughout higher education should consider any potential appearance-based bias they may hold, and invoke strategies to manage that bias" (Gulledge, Triangle Business Journal, 6/5; Duke Health release, 6/4).

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