title: Letters of recommendation to an otolaryngology/head and neck surgery residency program: their function and the role of gender.
abstract: OBJECTIVE
  To ascertain common features and gender differences in letters of recommendation (LORs) for applicants to an otolaryngology/head and neck surgery (OHNS) residency program.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Seven hundred sixty-three LORs submitted to one OHNS residency program in 2006 were reviewed.
  
  
  RESULTS
  All 763 letters "recommended" the applicant for OHNS residency. Ninety-one percent of letters were written by men, 68.4% by male otolaryngologists (OTOs), 4.2% by female OTOs, and 33% by OHNS department chairs or division chiefs (100% men). A comparison of female and male letter writers revealed five categories with significant differences: female letter writers were more likely to call an applicant a "team player" (P = .000), "compassionate," (P = .001) and use strings of adjectives (P = .024). In contrast, they were less likely when compared with male letter writers, to mention an applicant's personal life (P = .003), or write "letters of minimal assurance" (P = .035). Evaluation of the letters by applicant gender revealed two findings: letter writers were more likely to use a gender term in letters for male applicants (P = .004), and male letter writers were more likely to make reference to a female candidate's physical appearance (P = .040).
  
  
  CONCLUSIONS
  LORs for OHNS residency universally advocate for the applicant. The letters are written predominately by the highest-ranking male OTOs in academic medicine. In the LORs, male and female applicants are described similarly. Male and female letter writers, however, often describe applicants in different ways regardless of applicant gender.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery and Pediatrics, Stanford University, Palo Alto, California 94305, USA. amessner@ohns.stanford.edu
authors.forename: Anna H
authors.initials: AH
authors.lastname: Messner
authors.forename: Erika
authors.initials: E
authors.lastname: Shimahara
mesh_terms: D015709:Correspondence as Topic; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D010036:Otolaryngology / Q000193:education*; D012189:Retrospective Studies; D012570:School Admission Criteria / Q000706:statistics & numerical data; D012737:Sex Factors; D014481:United States; D014956:Writing