Medscape: What advice would you give to any students who may be nervous about sending in a photo?
Waldman: This is tough... As someone who is interested in ethics, my answer is that if you ever feel uncomfortable about something ethically, then you shouldn't do it. If someone told me, "I don't feel comfortable sending a photo to these programs," then I would tell them that they shouldn't do it if they feel uncomfortable. However, individuals who submit a photo are probably at an advantage, as a vast majority of people are doing that.
Medscape: What would your advice be for faculty who may have concerns?
Waldman: I would say two things. One, if you are in a residency selection meeting or having a discussion with your fellow faculty about resident selection and someone says something discriminatory about an applicant—whether it's because of their photograph or something else—then you need to address that because it's inappropriate.
Two, I think that faculties who feel uncomfortable with this practice should discuss with their departments taking action to potentially—at least at a program level—not encourage the photographs with the applications. They don't have to. I don't think it ever hurts to ask, "Hey, is there a reason we're doing this practice?" If no one can give you a reason why a practice is occurring, then I think it's reasonable to challenge its existence.
Medscape: What are the next steps across all of residency in terms of this issue?
Waldman: The next step is a qualitative study that includes interviews with people who are involved in these processes, [asking them] about their experiences to gain an understanding of the role that something has. I do think people are always scared when discussing topics like discrimination—that whistle-blowing can lead to backlash.
I think this is important. The big thing that we're trying to get out there is just an awareness of the practice. Programs at an institutional level can enact change by saying, "Hey, we don't think this is right" and stop doing it. I think it's incumbent upon the programs to enact change because there is a power imbalance between programs and applicants. It is much more difficult for an applicant to exclude a photo than it is for a program to stop asking for photos.
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Cite this: Are Residency Application Photos Used for Discrimination? - Medscape - Nov 29, 2018.