Opportunities for Mitigating Bias in the Process and Priorities for Pediatric Chief Resident Selection

Objective: To describe the current processes and priorities for pediatric chief resident (CR) selection, to characterize pediatric CR demographics in the past 5 years nationally, and to identify opportunities for addressing bias in the process of pediatric CR selection. Methods: We used a cross-sectional study design with an anonymous national survey of pediatric program directors (PDs) through a web-based platform in January 2020. Results: A total of 92 of 200 (46%) of PDs responded. About 16% of CR are underrepresented in medicine (UIM) by race/ethnicity. The influential factors most commonly cited in selection were nominations from faculty (84%) and peers (77%), followed by fit with other co-chiefs (68%). Only 17% reported having a specific method to mitigate bias in CR selection, most commonly involving multiple stakeholders in the process. Conclusions: Current CR selection relies on processes with the potential to introduce bias. Programs have opportunities to address bias in the CR selection process by reevaluating methods vulnerable to bias, including peer/faculty nominations, fit with peers, ITE scores, and assessments through the use of more objective selection tools.