Concordance of leadership documentation in curricula vitae and recommendation letters among applicants for general surgery residency

Letters of recommendation (LOR) are vital to surgical residency applications. Our prior study demonstrated differences in letter content by applicant sex, including more frequent reference to leadership and awards for male applicants. This study evaluates if leadership activities and awards as documented by the applicant's curriculum vitae (CV) corroborate differences noted in corresponding recommendation letters. LORs and CVs for 2016–2017 surgery resident applicants selected for interview at single academic institution were analyzed for documentation of leadership and awards and assessed for concordance. 89 applicant CVs (45 male, 44 female) and 332 LORs (165 male, 167 female) were reviewed for evidence of leadership and awards. While 94 ​% of CVs had evidence of leadership, leadership was referenced in LORs more often for men than women (45 ​% vs 30 ​%, p ​= ​0.004). References to leadership skills (38 ​% vs 21 ​%, p=<0.001), elected/appointed office (33 ​% vs 16 ​%, p ​< ​0.001), and volunteer/work-related leadership role (12 ​% vs 3 ​%, p ​= ​0.001) occurred more commonly for men. Similarly, awards were present in 74 ​% of CVs without difference by sex but referenced more commonly for men compared to women (64 ​% vs 46 ​%, p ​= ​0.001). References to leadership and awards in LORs were more common for men than women applicants, which is not reflective of CV content. Although LOR need not recapitulate CVs, fair appraisal of leadership abilities is encouraged.