Osteopathic Medical School Graduates' Perceptions of Bias in the Transition to Residency in the United States: a national cross-sectional survey

<title>Abstract</title> <p>Background The number of US DO Seniors increased by more than 10% between 2020 and 2023. While the number of US DO Senior applicants to the Match increased by 13.0%, the proportion of DO Seniors among all matched PGY-1 applicants rose only modestly (from 18.4% to 19.6%). This study examines US DO Seniors’ reported experiences of perceived bias due to their degree during the residency selection process, and assesses whether perceived bias varies by specialty type, sex, race/ethnicity, and match outcome. Methods This is a cross-sectional survey study of a nationally representative sample of graduating students at all Colleges of Osteopathic Medicine. The survey opened after the 2023 NRMP Match® and closed in July 2023. Bias items in the survey had a response rate of 55%. Results A total of 2,435 students (62%) self-reported experiencing perceived bias due to their degree. The extent varied depending on the matching process, with the military match having the lowest rates of reported perceived bias (27%). Experiences of perceived bias were not associated with race or ethnicity; there was a strong association between sex and perceived bias (p &lt; 0.001). There was also a strong association between procedural and non-procedural specialties (p &lt; 0.001), with procedural specialty applicants experiencing greater rates of perceived bias. Conclusions Most US DO students reported perceptions of degree bias that impacted their transitions to residency. These perceived biases may result in harm to these students and may affect access to care especially for rural or underserved patients.</p>