Our study found that applicants to pediatrics residency wrote their personal statements with a highly analytical and moderately authentic style with positive emotional tone. Both males and females wrote in a non-assertive way, striking a tone that evenly balanced expertise and tentativeness.
The most notable finding in our study was that males applying to pediatrics used communal language on par with their female counterparts. This finding deviates from typical gender norm expectations, which would predict that males use social language less than females (7-12) and suggests that personal statement language is at least in part dictated by the applicant’s perception of specialty-specific values, regardless of gender norms for language use.
Students rotating through pediatrics, for example, are taught that family-centeredness is the gold standard in providing pediatric care (34-36). Students receive feedback on their family-centered rounding skills and may even be required to attend workshops on optimizing family-centered care (34, 35). This emphasis and evaluation of the pediatric trainee’s skills in relationship-centeredness demonstrates to the student applicant that communal traits are not only expected but highly valued by faculty in pediatrics. Additionally, mentor physicians helping to review and edit personal statements may encourage this career assimilation as they assist applicants in revising their personal statements.
Moreover, when males represent the minority in a workplace (36.6% male workforce in pediatrics in the US), social and professional pressure may exist that encourages communal behavior and speech (traits more often associated with females in prior studies) (7-11). Studies by Cejka and Eagly have shown that “to the extent that occupations were female dominated, feminine personality or physical attributes were thought more essential for success; to the extent that occupations were male dominated, masculine personality or physical attributes were thought more essential” (37). As such, males entering pediatrics might be subject to social and professional pressure to include anecdotes of communal relationships and utilize communal language more frequently than typical gender norms would predict.
The finding that applicants veer from typical linguistic gender norms as a means of describing alignment with specialty-specific values is consistent with the findings of Osman et al. and Ostapenko, et al. which previously examined personal statements for internal medicine and general surgery residencies (27, 28). While the primary aims of these studies were not to examine the influence of specialty-specific values on personal statement writing, the studies did find that the primary themes described by both male and female applicants were themes of agency, which gender norms would not typically predict for females. Unlike pediatrics, internal medicine and general surgery are male-dominated fields (62.1% and 79.4% male workforces in the US, respectively) (38). As such, the cultural values of these specialties likely favors an image of agency overall (i.e. academic rigor, technical expertise) (7), implicitly encouraging applicants, regardless of gender, to conform to these expectations.
In our study, we also found that applicants did not completely deviate from gender norms for language use. Males in our study used agentic language of reward more than females, consistent with gender expectations. This finding is also consistent with findings from internal medicine and surgery personal statements in which gender differences in minor themes were found (females described the importance of teamwork and communication, males utilized self-promoting anecdotes and descriptions of technical expertise) (27, 28). These findings suggest that despite the tendency to appeal to specialty-specific values for the majority of personal statement content, the use of gender normative language (agency for males, communality for females) will persist in subtle ways, thus indicating the pervasiveness of gender expectations on the applicant.
There are a few limitations to this study. The first is that although the LIWC program has been validated in social psychology literature and shown to have good reliability in using “marker words” in place of content coding (10), we could have missed words or ideas that would have been otherwise identified if context was considered. Our study population was drawn from those who interviewed with our program, rather than all applicants, which is a limitation. To select which applicants to interview, our program utilizes the most objective parts of the application (scores, grades, medical school) and only reviews the subjective portions (personal statements, extracurriculars, and MSPE) after the interview has occurred to help determine final applicant rank. Although this approach to interviewee selection significantly reduces the risk that our sample selected for a population that demonstrated program-preferred values, this remains possible. Finally, our study cannot be generalized to other fields of medicine. However, there remains a current gap in the literature focusing on understanding how language patterns vary by specialty, and generalizations across specialties should not be made until additional studies are undertaken specifically examining each specialty.
This is the first study to our knowledge that has characterized the linguistic qualities and gender differences of pediatric residency personal statements and considered ways in which professional specialty choice and gender expectations might dually shape the way an applicant writes. It is important for residency training programs to understand the implications of these subtle language findings in personal statement writing for two reasons. First, understanding the social pressures that may influence an applicant’s writing may help training programs determine how and whether to utilize the personal statement in their applicant ranking process, knowing that this subjective element of the application may result in unintended bias in the evaluation of the applicant’s “fit” for the program. Second, understanding the role of societal gender norms and expectations for communal language use by females and agentic language use by males and how those expectations may shift within a medical specialty will allow educators to consider ways in which these expectations enter the application process, particularly when reviewers are not attuned to their own expectations and bias, as well as other educational settings. The more we understand about these subtle linguistic effects in medicine, the better education and training we will be able to provide to residency application reviewers and medical educators who intend to create equitable application processes and learning environments.
In order to further understand the way specialty-specific expectations and gender norms enter the residency application process across medical fields, it would be important to perform linguistic analysis of personal statements from a wide array of specialties, including male-dominated fields (orthopedics, urology) and female-dominated fields (obstetrics). Finally, future studies could focus on applicants who identify as gender non-conforming (nonbinary, transgender identity), in order to understand the true breadth of gender differences in the application process, so as to provide residency programs with more complete understanding of how gender biases operate and to empower residency programs to optimize diversity, inclusion, and equity in the application process.