Radiologists: Are You Aware of Your Biases?

December 21, 2017
Jessica Levco

Watch out for biases in radiology.

Whether we know it or not, our own personal bias creeps into each decision we make. Especially when it comes to hiring, recruiting, and attracting new talent to a hospital.

During the RSNA 2017 session, “Unconscious Bias in Recruiting Radiologists,” three doctors talked about what attendees could do to counteract their own biases. The discussion was led by Elizabeth Oates, MD, Madelene Lewis, MD, and Katarzyna Macura, MD, PhD.

First, Be Honest 

Oates of the University of Kentucky College of Medicine started her presentation with a confession: She’s negatively-biased against men who wear white socks with suits, but positively-biased toward equestrians (her daughter is one).

By sharing her personal biases, she wanted attendees to think honestly about what biases they each hold - whether it involves race, sex, ethnicity, height, age, or social class.

“We have to accept that we all have certain biases and blind spots, even with our best intentions,” Oates said. “And it takes an effort to unlearn them.”

She encouraged attendees to check out Harvard University’s Project Implicit for a quick online quiz to test biases. She also urged attendees to stop using the term “good fit” in the hiring process.

“This is a really common expression in recruiting,” Oates said. “But when you say ‘good fit,’ you’re limiting yourself. You’re basically saying you want people to act like you. You need to broaden your horizon. If you don’t, you’ll keep hiring the same people - over and over again.”

How To Recruit More Female Radiologists

Lewis at MUSC Health gave an inside look into how students selected a residency and what they were looking for when they made a decision. She said word-of-mouth and residency websites play a big role in the beginning stages of decision-making process.

For example, on MUSC’s radiology recruitment website, there’s information that discusses how the program values diversity. Many candidates have said during an interview with MUSC that this all-inclusive language mattered to them. There’s also information about the Women in Radiology Group, an organization that gets together about five times a year for social events and networking.

“If every single picture on your website is a white male - what are you saying to your women and minority applicants?”

Lewis helped re-frame what the selection committee should look for when reviewing applicants. Here’s what the team committee concentrates on now:

• Grading applications on the same scale
• Avoiding inferring about family obligations or gaps in training
• Developing a consistent scale when rating answers during an interview
• Considering candidates from multi-tier schools
• “Blinding” applications as much as possible

At first, Lewis was met with some resistance when working with the selection committee about these proposed changes. The committee seemed uncomfortable about the changes and didn’t feel like they had any biases.

“If you are trying to do something similar at your hospital, realize that a lot of people feel like they don’t have any biases,” Lewis said. “But all of us do. Approach the conversation in a way that is supportive and optimistic - show how changes in recruiting can improve patient care.”

She also recommended these three books:

Blindspot: Hidden Biases of Good People
Thinking, Fast and Slow
Everyday Bias: Identifying and Navigating Unconscious Judgments in Our Daily LivesWhy Female Mentorship and Leadership Matter 
Macura of Johns Hopkins Medicine said the goal in radiology departments should be to recruit for excellence. That being said, she wanted the audience to be aware of how certain biases can creep into the hiring process.

“We have to be aware of our biases because we want to attract people with different perspectives,” Macura said. “If we all think alike - and keep hiring the same people who think like us - that’s not progress. And it’s also not about filling quotas. It’s about casting a wide net to make sure we don’t miss out on outstanding candidates.” 

To cast a wider net, she urged the audience to get more involved with taking leadership roles when it comes to developing medical school curriculum.

“It starts with radiology getting more exposure in medical school,” Macura said. “If you’re in a position at your faculty to get involved with the curriculum, see if you can get more students excited about radiology in their first or second year of medical school - instead of waiting until the fourth year when the field is introduced.”

In addition, she encouraged female radiologists to participate in lectures, mentorship roles, or social media.

“It’s important for young women to see other women like them in the field,” Macura said.

In a profession dominated by men (78%), she also discussed how important it is for men to be champions for their female peers.

“Our biggest advocates can be men,” Macura said. “Men are brothers, fathers, and husbands -and we know they want women to succeed. There are plenty of ways for men to be invited to this discussion and become our advocates.”