A Yale-led study suggests that implicit bias may account for disproportionately low black and Asian membership in the Alpha Omega Alpha Honor Medical Society.

Alpha Omega Alpha is a prestigious medical organization with chapters at medical schools across the country. Each chapter chooses its members from the top quartile of a given class year, based on a set of subjective criteria, said Dowin Boatright, a postdoctoral fellow at the Yale School of Medicine and first author of the study. According to the Alpha Omega Alpha website, these criteria include attributes such as leadership, professionalism and professional promise. Boatright described the selection process as opaque, but noted that the results were released into the public domain. The demographics of the students chosen reveal that white students are more likely to receive membership than their black or Asian counterparts.

The project from which this paper originated was initially focused on race and bias in the awarding of the Dean’s Letter, a performance evaluation that plays a large role in acceptance into residency programs after medical school.

“We were looking at our data, and we just happened to notice that there seemingly weren’t that many minorities accepted into the Alpha Omega Alpha,” Boatright said. “So we decided to look into that.”

The data set used in this study consists of 4,655 medical school graduates’ applications to 12 Yale residency programs, including pediatrics, internal medicine and surgery, Boatright said. He added that the first challenge the researchers faced was standardizing the applicants so that they could isolate race as a variable in the Alpha Omega Alpha selection process. In order to do this, they first looked at MCAT scores, the most objective measure of academic success in medical school. They then considered data on applicants’ records of community service, research publication and leadership experience — all criteria the Alpha Omega Alpha chapters consider when voting on an applicant. The bulk of the statistical analysis was then done in a program called Stata, said Edward Moore, professor of engineering at Central Connecticut State University, and co-author of the study.

The results indicate that controlling for qualification level, white students’ chance of obtaining Alpha Omega Alpha membership is approximately six times higher than that of black students and twice as high as that of Asian students. While the results showed that Hispanic students were not disadvantaged in the selection process, Boatright attributed this to the small sample size of that population.

The reasons behind these discrepancies may be cloaked in the subjective, non-transparent voting process, Boatright acknowledged. It is generally Alpha Omega Alpha-affiliated members of a school’s faculty who form the voting committee, he said, adding that this population is often skewed toward white males.

“Because that committee is generally of a certain background, it is possible that that committee prefers people of that same background in the selection process,” Boatright said.

However, this explanation is only part of the picture. The researchers suspect that minority students may be less likely to be in the top quartile of their class than their white peers. The grading process in medical schools, especially in later years, is overwhelmingly subjective, and at the hands of the faculty, according to Boatright. He postulated that the lack of transparency in both the grading process and the Alpha Omega Alpha selection process contributes to continued bias, as it is unclear what objectively sets the white students apart from their peers.

The Alpha Omega Alpha society has not publicly responded to the research as of yet, but the researchers have been in contact with the Alpha Omega Alpha president, who indicated an interest in learning more about issues of race in the organization. The society does not currently keep data on the demographics of its members, which the researchers hope will change going forward, according to Boatright.

“I think if that data were public, so that you knew that let’s say, 80 percent of incoming Alpha Omega Alpha members are white,” Boatright said. “That doesn’t correspond to the general population of medical students, so I think there would be some pressure to do something about that.”

The researchers said they plan on looking at a multiyear national sample size, and interacting with the Alpha Omega Alpha and other societies to learn more about the issue.

Fifty-seven members of Alpha Omega Alpha have been Nobel Laureates.