To the Editor:
The Gold Humanism Honor Society (GHHS) aims to promote humanism in health care. 1 To become a member, medical students nominate their classmates who embody qualities of integrity, excellence, compassion, altruism, respect, and empathy. In some specialties, GHHS membership is more highly regarded than Alpha Omega Alpha (AOA). 2 Indeed, GHHS members have 1.5 times higher odds of receiving interview invitations than nonmembers. 3 Unfortunately, as a peer nomination process, membership is influenced by social factors. At the time of nomination during the third year of medical school, MD–PhD students have recently joined a new cohort of classmates. This may result in MD–PhD students facing lower odds of being elected into GHHS.
To demonstrate this, we used data from the Texas Seeking Transparency in Application to Residency (STAR). The Texas STAR is a nationwide survey of 23,639 medical students from the 2018–2021 match cycles,4 of which 4,247 (18%) were members of GHHS. The survey response rate was 41% to 46%. After adjusting for United States Medical Licensing Examination Step 1 scores, class rank, number of honored clerkships, AOA status, research output, volunteer experiences, course remediations, and medical specialty, MD–PhD students had lower odds of GHHS membership compared with their MD-only peers (adjusted odds ratio [AOR]: 0.44; 95% confidence interval [CI]: 0.34–0.57; P < .001). This is in contrast to students in other dual-degree programs where they had higher odds of GHHS membership (MD–MS: AOR: 1.20; 95% CI: 1.04–1.37; P = .01; MD–MPH: AOR: 1.59; 95% CI: 1.38–1.84; P < .001).
We posit that the timing of GHHS’ selection process partially explains the discrepancy. The GHHS could address this issue in 3 ways. First, it could delay the timing of the selection process, so that MD–PhD students are better acquainted with their classmates at the time of the elections. Second, nomination requests could be sent to MD–PhD students who began their training with colleagues eligible for GHHS. Third, the GHHS could encourage MD–PhD students to consider nominating fellow MD–PhD students.
Although the nomination process could be improved, is it also possible that the lower membership of MD–PhD students in GHHS means they are less humanistic than their peers? GHHS members have been shown to have higher empathy, patient-centered views, and tolerance of ambiguity than nonmembers.5 But there is no evidence that MD–PhD students lack in the aforementioned personality traits. To increase membership of MD–PhD students in GHHS, we recommend implementing our 3 suggestions to better align recruitment with the structure of MD–PhD programs.
Acknowledgments:
The authors would like to sincerely thank the medical students who selflessly submitted their match results to the Texas Seeking Transparency in Application to Residency.
Funding/Support:
This work was supported by grants from the National Institutes of Health (F31 NS115447) to Dr. Benjamin Wissel.
Footnotes
Other disclosures: The data used in these analyses were de-identified and may be made available upon request to Dr. Angela Mihalic.
Ethical approval: This analysis of de-identified survey data was given exempt review approval by the University of Cincinnati Institutional Review Board.
Contributor Information
Benjamin D. Wissel, MD–PhD student, Medical Scientist Training Program, University of Cincinnati College of Medicine, Cincinnati, Ohio; Benjamin..
Zana Percy, MD–PhD student, Medical Scientist Training Program, University of Cincinnati College of Medicine, Cincinnati, Ohio..
Angela P. Mihalic, Distinguished teaching professor, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas..
Robert V. Ellis, Associate director, Medical Scientist Training Program, University of Cincinnati College of Medicine, and associate professor, Department of Family Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio..
Gurjit K. Khurana Hershey, Program director, Medical Scientist Training Program, and Department of Pediatrics, University of Cincinnati College of Medicine, and professor, Division of Allergy and Immunology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio..
References
- 1.The Arnold P. Gold Foundation. About Us https://www.gold-foundation.org/about-us. Accessed June 2, 2022.
- 2.National Resident Matching Program. Results of the 2021 NRMP Program Director Survey https://www.nrmp.org/wp-content/uploads/2021/11/2021-PD-Survey-Report-for-WWW.pdf. Published August 2021. Accessed June 10, 2022.
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