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The recent transition of the United States Medical Licensing Examination Step 1 to passfail grading provides an opportunity for more holistic review of candidate applications
The recent transition of the United States Medical Licensing Examination Step 1 to passfail grading provides an opportunity for more holistic review of candidate applications and more equitable selection processes. While it is generally positive, the change may lead selection committees to more heavily weigh more subjective tools such as letters of recommenda tion (LORs) in candidate evaluation. The language in LORs may reveal the writer's unconscious biases as well as provoke a reader's unconscious biases.1 By minimizing opportunities for unconscious bias, we can use language as an actionable lever to move the needle toward achieving more equitable processes along the recruitment pathway. LORs are uniquely positioned to give deep insight into how a candidate's skills and accomplishments manifest at the bedside. LORs can validate material shared elsewhere in an application and provide new information. Letter writers often know candidates bet ter than division chairs or program directors, who may not have worked with the candidates clinically
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