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Guidelines for Department of Medicine Search Committees Using an Equity, Diversity, and Inclusion Lens

Rationale:

The Department of Medicine (DoM) is considered a leader within the Temerty Faculty of  Medicine and beyond for our focus on equity, diversity, and inclusion (EDI) for faculty members,  trainees, and patients. There is copious evidence that diverse teams offer a variety of viewpoints  and wider range of experiences, which improves decision-making & problem-solving,  productivity, career satisfaction & retention, engagement, fosters innovation, promotes  organizational values, and perhaps most importantly, has potential to reduces disparities in  health care access and outcomes for our patients.  

There are many aspects of people’s identities that may result in inequities and/or  discrimination, including (but not limited to) sex and gender, age, race, ethnicity, religion,  Indigeneity, self-identification as LGBTQ2S+, disability, childhood socioeconomic status, and  immigration status. We are committed to ensure that the DoM is representative of the learners  we educate and the communities we serve, and to aligning diversity in hiring with support and  inclusion in the DoM community.

Goal: 

To ensure equitable and inclusive search and recruitment processes in the DoM. Equity and  inclusion are as much about the process as about the end result of the search process.

Advertise the Position

  • Strive to identify a diverse applicant pool by:
    • Broaden the description of qualifications via a holistic* approach
    • Engage in active outreach to select societies/organizations and equity deserving  groups 
    • Use of broad, informal networks to advertise positions
  • Aim for a diverse applicant pool; consider extending the search if this is not achieved • Include a statement about the University’s promotion of diversity and equity (mandatory at Temerty Faculty of Medicine)
  • Request applicants to: 
    • Submit a statement on how they have demonstrated commitment to EDI in their  academic and scholarly work (must be done for leadership searches) – this can  be further explored in the interview
    • State any impact of COVID-19 or other life circumstances on their career  trajectory if applicable (optional)

Establish Search Committee: 

  • The chair of the search committee is responsible for ensuring a fair and equitable  search, which should incorporate the following: 

 1. Confidentiality of all discussions; and 

 2. Awareness throughout the process of the phenomena of unconscious bias** and   institutional reproduction***.

  • Identify the stakeholder groups that should be represented on the committee, e.g., stages of career, hospital sites, position descriptions, hospital and departmental  leadership
    • Ensure that the individuals invited to represent these stakeholder groups reflect  the diversity of the DoM by gender (~ 40% women) and that at least 1/3 of  committee members either belong to equity deserving groups e.g., Black,  Indigenous, and People of Colour (BIPOC) or individuals with expertise in EDI to  reduce the so-called “minority tax” on faculty of colour. 
    • Review the draft committee membership and ask: “who is missing?” And  “why?” - address any gaps.

• Ensure that the committee membership remains the same throughout the recruitment  process

Standardise the Interview and Candidate Selection Process

  • Establish agreement on credentials/qualifications for the position in advance of  interviews (often these qualifications cannot be readily identified from a CV) and the  evaluation criteria (see appendix 2 for example) 
  • In selecting which applicants to interview, do not penalize candidates for ‘CV gaps’ that  may coincide with parental/family leaves or other personal matters
  • Highlight the department’s progress in achieving EDI goals in selection and recruitment  process 
  • Use standardised questions and structured interviews to elucidate candidate’s suitability  for the position 
  • Ensure sufficient time is available to discuss each applicant
  • Compare responses to the interview questions horizontally, across candidates, question  by question, benchmarked to the agreed-upon qualifications for the position
  •  Rank candidates after thorough discussion using private ballot instead of open ranking  to avoid peer pressure
  • Consider a second interview if there are outstanding questions or concerns about one or  more applicants – if two are being considered, re-interview both
  • Do not require letters of reference until later in the recruitment process o Raise awareness that letters of reference may reflect unconscious bias  (see appendix 1 for examples)

Monitor the process

  • Task one search committee member, who is committed to and understands EDI  principles, to monitor and document the search process with respect to EDI principles;  ask this individual to intervene if they feel there has been a violation of the expectations  for fairness and equity. Other members should take responsibility for doing so as well.
  • Have committee members reflect on what went well and what could have been done  better at the conclusion of each search 

Beyond the Search Process  

  • Commit to supporting the successful candidate with mentorship/coaching to facilitate  their transition and integration in the DOM – provide an appropriate orientation 
    Review the search processes regularly, including decisions made, and progress towards  equity goals
  • Continue to enhance the culture of inclusion for the Department such that diversity in  hiring is aligned with support and inclusion in the DoM community
  • Consider using the DOM self-identification survey results to establish hiring goals for  equity deserving groups and BIPOC candidates 

* Holistic Review is a flexible, individualized way of assessing an applicant’s capabilities by  providing balanced consideration to their experiences, attributes, and academic metrics to  ascertain how the candidate might contribute meaningfully as a future Department of  Medicine’s faculty member/leader in alignment with the departmental vision and priorities.

**An unconscious bias is an implicit attitude, stereotype, motivation or assumption that can  occur without one’s knowledge, control or intention. Unconscious bias affects all types of people  and can be found in men and women. Examples of unconscious bias include gender bias, racial  bias, and ageism.

***The ways in which institutions are organized and governed transmit their institutional norms  from generation to generation, and individuals within those institutions are socialized to expect  things to be a certain way. This phenomenon maintains the power and advantages of groups  that have traditionally held those advantages and makes it harder for those from groups that  have traditionally been less powerful to be successful and become leaders. The identification of  this phenomenon of cultural reproduction, including pointing out assumptions that advantage  or disadvantage certain groups, helps to disrupt the cycle, thereby enabling positive change

Resources:

  • Suggested Networks to post:
    • Canadian Society of Internal Medicine (CSIM)
    • Canadian Medical Association (CMA)
    • Ontario Medical Association (OMA)
    • Subspecialty organisations e.g. Canadian cardiovascular society, Canadian society  for endocrinology and metabolism, etc.
  • Suggested Networks to post for Groups currently underrepresented in the Department  of Medicine 
  • Temerty Faculty of Medicine EDIIA guidelines document: 
    https://drive.google.com/file/d/14ErvYb-Dh4hOig28uvzGp984eU0m3CPa/view
  • Reducing Bias in Academic Search Committees 
    (https://jamanetwork.com/journals/jama/article-abstract/2594729) 
  • Interview guide/question suggestions on how to ask about EDI related work and  experience (few examples are shared below)
    • In your past experience, how have you fostered equity, diversity and inclusion at  work?
    • What would be your approach to further EDI mission in this role (for the position  they are being interviewed)? 
    • How do you approach interactions with health professionals from diverse backgrounds?

Appendix 1

In a linguistic analysis of letters of reference for faculty hired at a major medical school in the  US, differences were noted between letters written for men and women. Letters written for  female applicants were shorter and less focused on the candidate’s record of accomplishment.  They used more gendered terms such as ‘intelligent young lady’.

  • Letters for women included more grindstone adjectives such as: hardworking,  conscientious, dependable, careful, dedicated or meticulous.
  • Letters for men included more standout adjectives such as excellent, superb,  outstanding or unique.

This finding suggests that women’s success is more often associated with effort while men’s  success is associated with ability.

  • Letters written for female applicants included more references to personal life than  those written for men.
  • Letters written for men were more likely to have references to their CV, publications or  patents.
  1. Trix F., & Psenka, C. Exploring the Color of Glass: Letters of Recommendation for Female  and Male Medical Faculty. Discourse & Society, 2003; 14(2), 191- 220.
    https://doi.org/10.1177/0957926503014002277
  2. Madera JM, Hebl MR, Martin RC. Gender and letters of recommendation for academia:  agentic and communal differences. J Appl Psychol. 2009 Nov;94(6):1591-9. doi:  10.1037/a0016539. PMID: 19916666.
  3. Lin, F., Oh, S.K., Gordon, L.K. et al. Gender-based differences in letters of recommendation  written for ophthalmology residency applicants. BMC Med Educ 19, 476 (2019).  https://doi.org/10.1186/s12909-019-1910-6
  4. Schmader T, Whitehead J, Wysocki VH. A Linguistic Comparison of Letters of  Recommendation for Male and Female Chemistry and Biochemistry Job Applicants. Sex  Roles. 2007;57(7-8):509-514. doi: 10.1007/s11199-007-9291-4. PMID: 18953419; PMCID:  PMC2572075.

*The Department of Medicine interprets the word "female" as fully inclusive of all self-identified  trans and cis women.

Appendix 2