Are Residency Application Photos Used for Discrimination?

Ryan Syrek, MA

Disclosures

November 29, 2018

In the November 2018 issue of Academic Medicine, Reid Waldman, MD, and his colleagues published "The Ethical and Legal Conundrum Posed by Requesting Residency Applicants to Submit Photographs of Themselves." The authors asserted that the nearly universal practice of encouraging medical students to submit professional headshots along with their residency applications opens them up to discriminatory judgments while providing little substantive positive value.

We spoke with Dr Waldman about his investigation into this practice and what recourse is available for students and faculty who have concerns.

Medscape: What prompted you to prepare that piece for Academic Medicine?

Waldman: We started working on it during last year's admission cycle. We spent a lot of time talking about the admissions process for another paper that we'd done. One of the authors is a lawyer. We started talking about whether it is legal, from a federal stance, to ask someone for a photograph with their application. I think that almost every program encourages it.

We found that institutions don't require you to submit a photograph. If they did, that that would probably be in violation of Equal Employment Opportunity Commission (EEOC) regulations. Even though it's not required—as in, you can still submit an application without it—it's required, in the sense that if you don't, that really distinguishes your application, maybe in a negative way, from those around you. It's the very first thing you see. It's big, in the top right corner of the applications. I asked people who are involved in selections what they would think if an applicant didn't submit a photo. They said, "Well, that would seem kind of weird..."

So we were curious about how submitting photos affected people and whether that caused discrimination. All we could find was an article about medical schools in Britain. The authors thought that there was discrimination against ethnic minorities, based on identifying information in applications for medical school. They thought that if you eliminated that, discrimination down the line was decreased.

I think the photograph in and of itself is a special kind of identifier that is unnecessary. The photograph does not provide useful information that is necessary for selecting qualified candidates. Unless there's a compelling argument for why you need a photograph, which so far no one has brought to me, I think it is unnecessary. Everyone I've shown the article to has agreed with our point of view. I am concerned that this is a possibly illegal practice, that it can cause people to be discriminated against, and that it is unfair.

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