Background: National data document that hospital medicine groups frequently lack representative diversity in terms of race, ethnic background and gender. This diversity gap further expands with career development and promotion. Traditional physician hiring strategies are susceptible to elements of bias that may contribute to these disparities.
Purpose: To design and implement a structured process for faculty hiring that can be objectively evaluated to address elements of bias.
Description: Our academic hospital medicine group (HMG) established a hiring committee (HC) tasked with restructuring our physician hiring process. Our prior hiring process utilized an informal review of a candidate’s CV, letters of reference and an unstructured interview with hiring decisions based upon consensus by members of our HMG leadership team. The HC reviewed processes from external organizations and sought input from our institution’s Center for Diversity and Inclusion to develop a new hiring process. This resulted in a structured evaluation process based on five domains reflecting core attributes of our HMG. • Clinical Skills or Excellence, • Academic Potential or Scholarship, • Teaching Potential or Proficiency, • Professionalism,• Contribution to Diversity or Equity The HC developed a descriptive rubric and summative assessment tool to guide reviewers in scoring. Candidates are scored from 1-5, with 5 given to the most qualified candidates. HC members were trained, and the assessment tool and scoring methods were refined until highly consistent results between reviewers were achieved.To implement the new hiring process at least two reviewers evaluated each applicant pre-interview. Reviewers utilized the applicant’s CV, cover letter and letters of reference to assign a score for each domain. All applicants were reviewed at a weekly HC meeting. Applicants receiving discordant scores were discussed in more detail until the HC reached consensus and applicants with the highest scores were invited to interview. Interviews were conducted with at least three faculty trained in the use of the rubric and summative assessment tool. Interviews were guided by a list of structured questions used to elicit details and dialogue about each of the five domains. Post-interview scores were similarly reviewed at a weekly HC meeting, with group discussion of discordant scores. Final assessment scores were then used to guide hiring decisions. During the 2019 hiring season our HC reviewed more than 100 candidates, and achieved a R coefficient for correlation between faculty reviewers of 0.68
Conclusions: Our HMG established a HC to develop and implement a structured hiring process that can be objectively evaluated to reduce implicit bias and promote hiring of diverse faculty. Importantly, use of this new process allows for objective measurements including: consistency between reviewers and interviewers (a potential source of individual bias), and comparison of different candidates (a potential source of bias towards certain types of candidates). Future work includes assessment of diversity among our faculty in correlation to use of this new hiring process.