At this year's AAPM Annual Meeting there was a well-attended SAM session on Wednesday afternoon entitled "Discharging the Bias: Recognizing and Addressing Unconscious Bias in the Workplace." The large crowd of attendees was welcomed to the unique session by Laura Cerviño, PhD, an Associate Professor in the Department of Radiation Medicine and Applied Sciences at the University of California, San Diego. She began with a simple question, "Why should medical physicists think about unconscious bias?"

Slides showing the breakdown of AAPM membership by race and gender flashed onto the screen, showing that while the group's makeup has changed over time, we are still a professional society that is overwhelmingly white and male. Studies have shown that diversity enriches innovation, performance, well-being, and problem solving—and that unconscious bias can adversely affect diversity.

To get to the root of the matter, we need to know what unconscious bias is—these are attitudes and beliefs we have about a person or group on an unconscious level, things that are subtly impactful on our actions and hard to recognize even from within ourselves. They develop at a young age, and progress throughout childhood. They are not intentional or cultivated, and they can be deeply impactful on our professional lives.

Examples of unconscious bias include studies showing that when similarly strong CVs are sent to employers, both male and female reviewers are more likely to hire the candidate with the male name. And, more strikingly, when candidate pools contain only one woman, there's statistically no chance that she will be hired.

This introduction was followed by a panel discussion from: Maryellen Giger, PhD, FAAPM, Professor of Radiology/Medical Physics at the University of Chicago and winner of the AAPM Coolidge Award; Indrin Chetty, PhD, FAAPM, Professor and Head of Radiation Physics in the department of Radiation Oncology at Henry Ford Health Systems; Julianne Pollard-Larkin, PhD, Assistant Professor of Radiation Physics at MD Anderson Cancer Center; and Kristi Hendrickson, PhD, Assistant Professor of Radiation Oncology at University of Washington. Moderators were Laura Cerviño and Jean Moran, PhD, FAAPM, Professor and Co-Director of Medical Physics at University of Michigan Medical Center. This distinguished group answered questions related to their own personal experiences with diversity, unconscious bias, and striving for a more equitable workforce.

Indrin Chetty spoke about how to minimize unconscious bias in the hiring process, including using a blinded review of the CVs to level the playing field and separate candidates from their demographics, and standardizing the interview format so that all candidates are asked the same questions. He also recommended setting diversity goals with team members to bring the issues to the forefront and permit open discussion of what can be a sensitive topic.

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Maryellen Geiger was asked about changes that she has seen since the beginning of her career. She mentioned that until a few years ago, unconscious bias wasn't really on her radar. "I just thought that was the way it was. I wasn't looking for it." But after her university began compiling statistics, she started to see how unconscious bias was influencing decisions and demographics. She also mentioned that at her university it is now acceptable to call out when there aren't enough diverse candidates in a pool. This wouldn't give preferential treatment to those candidates—they still need to stand on their merits and experience to be selected as the right person for the position—but having a suitably diverse pool is valued.

Kristi Hendrickson shared her recent published work about what questions are being asked of our newest potential coworkers—those participating in the medical physics match. From 2015-2018 the numbers of applicants who report being asked about their marital status, their plans to have children, and their religion have remained high. She also shared data from the survey respondents that if the applicant was asked about their marital status or their family goals, women were much less comfortable answering than their male counterparts (see her article "MedPhys Match and Discriminatory Behavior in the Residency Search Process" in this edition of the newsletter for a detailed analysis).

Julianne Pollard-Larkin offered strategies for overcoming unconscious (and also explicit) bias, from her unique perspective as an African-American woman in a STEM field. She has risen to a level in her career where she can be part of the residency search committee, to help serve as a gatekeeper for the illegal and unfair questions that Dr. Hendrickson's work spotlighted. She brought up that minority students can be disadvantaged from the very beginning, because they are less likely to have worked with a "big name" in the field. As we are a small field, where "everybody knows everybody" the potential detriment of not having a big-name collaborator or advisor on one's CV can be crushing even at the early stages of a career.

Following the planned question and presentation portion, multiple audience members stepped up to the microphone to share their experiences, ask about situations which they've been involved in, and wonder how they and the community can do better. Questions and comments included:

• I have been part of a selection committee, and it took a few years before I recognized my own unconscious bias. I found that I was a woman, who was unintentionally setting the bar higher for female candidates. Could CAMPEP blind the applications to things like gender and race?
• One thing I did not hear mentioned is the issue of mentorship. "Like begets like" which is very hard when a junior level female medical physicist is seeking mentorship from one of our few female senior-level leaders. Are there comments about this issue?
• Reaching out to the community to increase female representation in STEM programs is so important. I really appreciate the panel, and feel more empowered to talk about this topic. Can we discuss salary differentials between men and women? Pay based on education and experience should be the norm.
• Every year I meet new graduate students who are trying to diversify their programs. Do you have recommendations for how to push faculty to make the time for these initiatives?
• The issues that women in private practice and community hospitals face are likely different from those of women in academia. Can we look into those differences in the future? And how can those community clinics help to diversify their applicant pools, to start the process of getting female physicists in the door?

Responses to the above questions, and the entire presentation, can be found in the AAPM Virtual Library.