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Implicit Racial Bias in Medical School Admissions

Capers, Quinn IV MD; Clinchot, Daniel MD; McDougle, Leon MD; Greenwald, Anthony G. PhD

doi: 10.1097/ACM.0000000000001388
Innovation Reports

Problem Implicit white race preference has been associated with discrimination in the education, criminal justice, and health care systems and could impede the entry of African Americans into the medical profession, where they and other minorities remain underrepresented. Little is known about implicit racial bias in medical school admissions committees.

Approach To measure implicit racial bias, all 140 members of the Ohio State University College of Medicine (OSUCOM) admissions committee took the black–white implicit association test (IAT) prior to the 2012–2013 cycle. Results were collated by gender and student versus faculty status. To record their impressions of the impact of the IAT on the admissions process, members took a survey at the end of the cycle, which 100 (71%) completed.

Outcomes All groups (men, women, students, faculty) displayed significant levels of implicit white preference; men (d = 0.697) and faculty (d = 0.820) had the largest bias measures (P < .001). Most survey respondents (67%) thought the IAT might be helpful in reducing bias, 48% were conscious of their individual results when interviewing candidates in the next cycle, and 21% reported knowledge of their IAT results impacted their admissions decisions in the subsequent cycle. The class that matriculated following the IAT exercise was the most diverse in OSUCOM’s history at that time.

Next Steps Future directions include preceding and following the IAT with more robust reflection and education on unconscious bias. The authors join others in calling for an examination of bias at all levels of academic medicine.

Q. Capers IV is associate professor of medicine (cardiovascular medicine), Ohio State University College of Medicine, Columbus, Ohio.

D. Clinchot is professor of physical medicine and rehabilitation, Ohio State University College of Medicine, Columbus, Ohio.

L. McDougle is associate professor of family medicine, Ohio State University College of Medicine, Columbus, Ohio.

A.G. Greenwald is professor of psychology, University of Washington, Seattle, Washington.

Funding/Support: None reported.

Other disclosures: Quinn Capers IV, Daniel Clinchot, and Leon McDougle have no conflicts of interest to disclose. Anthony G. Greenwald is an officer in Project Implicit, Inc., a nonprofit corporation that has as part of its scientific mission “to develop and deliver methods for investigating and applying phenomena of implicit social cognition, including especially phenomena of implicit bias based on age, race, gender or other factors.”

Ethical approval: This study was ruled exempt for ethical approval by the Ohio State University institutional review board.

Previous presentations: Portions of these data and the overall summary were presented at the Association of American Medical Colleges Admissions and Student Diversity Affairs Professional Development Conference, Miami, Florida, June 18–21, 2015.

Correspondence should be addressed to Quinn Capers IV, Ohio State University College of Medicine, 370 W. 9th Ave., Columbus, OH 43210; telephone: (614) 685-3052; e-mail:

© 2017 by the Association of American Medical Colleges