Health professions school applicant experiences of discrimination during interviews

Background Bias pervades every aspect of healthcare including admissions, perpetuating the lack of diversity in the healthcare workforce. Admissions interviews may be a time when applicants to health profession education programs experience discrimination. Methods Between January and June 2021 we invited US and Canadian applicants to health profession education programs to complete a survey including the Everyday Discrimination Scale, adapted to ascertain experiences of discrimination during admissions interviews. We used chi-square tests and multivariable logistic regression to determine associations between identity factors and positive responses. Results Of 1115 respondents, 281 (25.2%) reported discrimination in the interview process. Individuals with lower socioeconomic status (OR: 1.78, 95% CI [1.26, 2.52], p = 0.001) and non-native English speakers (OR: 1.76, 95% CI [1.08, 2.87], p = 0.02) were significantly more likely to experience discrimination. Half of those experiencing discrimination (139, or 49.6%) did nothing in response, though 44 (15.7%) reported the incident anonymously and 10 (3.6%) reported directly to the institution where it happened. Conclusions Reports of discrimination are common among HPE applicants. Reforms at the interviewer- (e.g. avoiding questions about family planning) and institution-level (e.g. presenting institutional efforts to promote health equity) are needed to decrease the incidence and mitigate the impact of such events.

Automated summary

Background bias is prevalent in healthcare, including admissions, leading to a lack of diversity in the healthcare workforce. Admissions interviews can be discriminatory towards applicants, with lower socioeconomic status and non-native English speakers more likely to experience discrimination. Reforms are needed at the interviewer and institution level to reduce discrimination and its impact.