Transparency of Alpha Omega Alpha Selection Processes and Bias Mitigation Across US Medical Schools: A Cross-Sectional Mixed Methods Study.

Abstract

Membership in the Alpha Omega Alpha (AOA) honor society has long-term professional benefits, including improved match outcomes, yet racial and socioeconomic disparities in membership are well-documented. AOA selection processes across schools lack standardization, complicating understanding of the meaning of membership. To analyze transparency and methodology of AOA selection processes nationally and describe chapters' acknowledgement of potential for bias. Researchers performed a mixed methods cross-sectional study of medical school websites describing AOA chapter eligibility and selection in the United States (US) from October 2023 to April 2024. Descriptive statistics were generated to characterize quantitative data, and thematic analysis was performed to identify patterns within extracted quotes. LCME-accredited, MD-granting medical schools in the US. Researchers iteratively refined a data extraction form focused on AOA chapter status, eligibility and selection criteria, and quotes acknowledging potential for bias. Both thematic and content analyses were used with extracted quotes, while descriptive statistics were calculated for quantitative data.  KEY RESULTS: Of 157 medical schools nationally, 131 (83%) had an active AOA chapter. Of these, 98 (75%) referenced eligibility and/or selection procedures. Personal characteristics (55%), review of accomplishments (51%), and an academic cut-off (18%) were the most common selection criteria. Twenty-seven schools (17% of all schools, including four with recently closed chapters) acknowledged potential for bias, and eight themes were generated to characterize bias acknowledgement. Most medical school websites described AOA evaluation methods, which were variable across schools. Few schools acknowledged potential for bias. Given these findings, future studies should explore the current interpretation of AOA membership with emphasis on bias mitigation at the residency level and beyond. Not applicable.