Medical student spent six months investigating whether an AI screening tool rejected his residency applications

Chad Markey, a final-year medical student at Dartmouth with strong credentials—including publications in the Journal of the American Medical Association and The Lancet, and a professor's letter calling him exceptionally skilled—received only outright rejections and no interview offers after applying to 82 residency programs. He suspected an AI screening tool used by some hospitals had misinterpreted language in his Medical Student Performance Evaluation.

Markey's MSPE described three leaves of absence totaling about 22 months as "voluntary," but they were medically necessary due to ankylosing spondylitis (an autoimmune disease affecting the spine that left him unable to walk for six months). He believed an automated screening tool might flag the word "voluntary" and downgrade his application without understanding the medical context.

Only a handful of states regulate AI hiring screening tools. Illinois, New Jersey, and Colorado prohibit discriminatory tools but require limited transparency beyond notifying applicants that AI is used. California requires employers to regularly test AI hiring tools for bias. No existing rules allow an individual to understand how a particular AI tool judged their application or whether it discriminated against them.

Starting in 2025, the Association of American Medical Colleges announced a partnership with Thalamus to offer Cortex, a screening tool for residency applications, free to hospitals.