Virtual Interviews During COVID-19: The New Norm for Residency Applicants

Perspectives on Application and Interview Capping in Residency Selection of Surgical Subspecialties

OBJECTIVE

With the advent of virtual interviews, the potential for interview hoarding by applicants became of greater concern due to lack of financial constraints associated with in-person interviewing. Simultaneously, the average number of applications submitted each year is rising. Currently there is no cap to the number of applications or interviews an applicant may complete when applying to residency, with the exception of ophthalmology with a cap of 15 interviews. No studies have assessed the applicants' perspectives on an application or interview cap. We assessed the attitudes of surgical subspecialty applicants towards capping, which may be useful when considering innovations in residency selection.

DESIGN/SETTING/PARTICIPANTS

About 1841 applicants to the Johns Hopkins' ophthalmology, urology, plastic surgery, and orthopedic surgery residency programs from the 2022-2023 cycle were invited to respond to a 22-item questionnaire. Statistical analyses of aggregate data were conducted using R.

RESULTS

Of the 776/1841 (42%) responses, 288 (40%) were in support of an application cap, while 455 (63%) were in support of an interview cap. Specialty (p < 0.001), gender (p < 0.001), taking a gap year (p = 0.02), medical school region (p = 0.04), and number of interviews accepted off of a waitlist (p = 0.01) were all significantly associated with a difference in opinion regarding an application cap. Specialty (p < 0.001), USMLE Step 1 score (p = 0.004), number of interviews (p < 0.001), and number of programs ranked (p < 0.001) were all significantly associated with a difference in opinion regarding an interview cap. Of those applicants who were in support of the respective caps they believed that on average a cap should consist of 48.1 (16.1) applications and 16.0 (8.0) interviews.

CONCLUSIONS

Our findings highlight the desire for interview caps among the majority of applicants to surgical subspecialties and thus this innovation may be considered by other specialties in the era of virtual interviews.

The Impact of Virtual Residency Interviews on the Geographic Distribution of Integrated Interventional and Diagnostic Radiology Residency Matches

PURPOSE

To characterize how the adoption of virtual residency interviews (2020-2021 cycle) has impacted the geographic distribution of radiology resident matches.

METHODS

University-based interventional (IR) and diagnostic radiology (DR) residency programs from 2017 to 2021 were identified using a national residency database (FRIEDA). Public applicant data were obtained from official residency program websites. Medical schools and residency programs were categorized by US census regions. Geographic applicant distribution before and after the initiation of virtual interviews was statistically assessed using Chi-square tests. The effect of virtual interviews on the probability of matching within the same geographic region as one's medical school was evaluated with multivariate logistic regression.

RESULTS

4358 radiology residents (88% diagnostic, 12% interventional) matched at 102 radiology programs during the study period. 71% (n = 3115 residents) had data available for analysis. 56.3% of DR and 49.3% of IR residents matched in the same geographic region as their medical school. The geographic distribution of applicants who matched at Southern IR residency programs significantly changed after implementation of virtual interviews (p < 0.0001). Virtual interviews did not increase the odds of matching in the same region as one's medical school for IR (OR 1.11, p = 0.08) or DR (OR 1.01, p = 0.58) applicants. Top-20 ranked DR programs had lower odds of in-region matches (OR 0.87, p < 0.001).

CONCLUSION

With few exceptions, shifting to virtual residency interviews did not significantly affect the geographic distribution of IR or DR residency matches. Top-ranked DR programs match more regionally diverse applicants.

A cost analysis of medical students applying to neurological surgery residency: An analysis of the Texas STAR database

INTRODUCTION

Medical Students applying to neurosurgery residency programs incur substantial costs associated with interviews, away rotations, and application fees. However, few studies have compared expenses prior to and during the COVID-19 pandemic. This study evaluates the financial impact of COVID-19 on the neurosurgery residency application and identifies strategies that may alleviate the financial burden of prospective neurosurgery residents.

METHODS

The TEXAS STAR database was surveyed for applicants of neurosurgical residency programs during the COVID-19 pandemic (2021) and post-pandemic (2022). 66 applicants for the 2021 application cycle and 50 applicants for the 2022 application cycle completed the survey. We compared application fees, away rotations cost, interview cost, and total expenses as reported by the neurosurgery applicants of the 2021 and 2022 application cycle. A Shapiro-Wilk test was used to test for data normality, and a Mann-Whitney U-Test was used to compare costs during the 2021 and 2022 neurosurgery application cycle.

RESULTS

There was a statistically significant reduction in total expenses in 2021 vs 2022 ($3,934 vs $9,860). Interview and away rotation expenses decreased in 2021 vs 2022 (interview expenses $786 vs $4511, away rotation $1,083 vs $3,000, p < 0.001). Application fee expenses were not different between 2021 and 2022. The greatest reduction in application cost ($11,908) was seen in the South for 2021.

CONCLUSIONS

The COVID-19 pandemic significantly reduced total fees associated with the neurosurgical residency application. Virtual platforms in place of in-person interviews could lessen the financial burden on applicants and alleviate socioeconomic barriers in the neurosurgical application process after COVID-19.

Effects of candidates' demographics and evaluation of the virtual Multiple Mini Interview (vMMI) as a tool for selection into paediatric training in Queensland

INTRODUCTION

The Queensland Basic Paediatric Training Network (QBPTN) is responsible for the selection of candidates into paediatric training in Queensland. The COVID-19 pandemic necessitated interviews to be conducted 'virtually' as virtual Multiple-Mini-Interviews (vMMI). The study aimed to describe the demographic characteristics of candidates applying for selection into paediatric training in Queensland, and to explore their perspectives and experiences with the vMMI selection tool.

METHODOLOGY

The demographic characteristics of candidates and their vMMI outcomes were collected and analysed with a mixed methods approach. The qualitative component was comprised of seven semi-structured interviews with consenting candidates.

RESULTS

Seventy-one shortlisted candidates took part in vMMI and 41 were offered training positions. The demographic characteristics of candidates at various stages of selection were similar. The mean vMMI scores were not statistically different between candidates from the Modified Monash Model 1 (MMM1) location and others [mean (SD): 43.5 (5.1) versus 41.7 (6.7), respectively, p = 0.26]. However, there was a statistically significant difference (p value 0.03) between being offered and not offered a training position for candidates from MMM2 and above. The analysis of the semi-structured interviews suggested that candidate experiences of the vMMI were influenced by the quality of the management of the technology used. Flexibility, convenience, and reduced stress were the main factors that influenced candidates' acceptance of vMMI. Perceptions of the vMMI process focused on the need to build rapport and facilitate communication with the interviewers.

DISCUSSION

vMMI is a viable alternative to face-to-face (FTF) MMI. The vMMI experience can be improved by facilitating enhanced interviewer training, by making provision for adequate candidate preparation and by having contingency plans in place for unexpected technical challenges. Given government priorities in Australia, the impact of candidates' geographical location on the vMMI outcome for candidates from MMM >1 location needs to be further explored.

Neurosurgery Applicant Perspective of Neurosurgery Residency Websites

OBJECTIVE

Applicants rely heavily on virtual information in the form of neurosurgery residency websites (NRWs) to better understand a program's culture, faculty, and opportunities. There is a paucity of information regarding the value of NRW on applicant decision making. The advent of the supplemental ERAS application and continuation of virtual interviews may increase the propensity of which applicants use NRW. The objective of our study was to distribute a survey to further understand applicants' perceptions and opinions of NRW, as well as provide future direction for NRW optimization.

METHODS

The current study is a single-institution, retrospective survey design. A survey was designed via Qualtrics software to evaluate applicant demographics, resident education, resident recruitment, and future directions. The survey includes the most frequently used variables on NRW. The survey was distributed to neurosurgery applicants who received an interview at the University of Alabama at Birmingham. Data were analyzed using Microsoft Excel.

RESULTS

Among the 293 applicants who received a link to the survey, 87/293 (29.7%) completed it. Respondents elected that useful website variables were "resident rotation schedules and hospital locations," "faculty listings and biographies," and "neurosurgery residency websites served as a first impression of a neurosurgery residency program." More than half of the respondents agreed that their rank list would not be the same without an NRW. The most strongly received statement for future directions was "Neurosurgery residency programs will benefit from renovating their residency website."

CONCLUSIONS

Our data suggest NRWs play a vital role in resident recruitment and decision making. Residency programs will benefit from this data and may use it to restructure their virtual recruitment tools and discover innovative virtual recruitment strategies. Our team elucidated the most important variables found on NRWs and proposed future directions for their improvement and the virtual application and recruitment process.

A Leadership Perspective on the Plastic and Reconstructive Surgery Residency Application Cycle during the COVID-19 Pandemic

Introduction

The purpose of this study was to identify leadership perspective on the impact of COVID-19 Plastic and Reconstructive Surgery residency application cycle in 2020 and future implications.

Methods

A survey was sent to residency program leaders (RPL), consisting of program directors and division chiefs/chairs. The survey was sent weekly for a total of 4 weeks and remained open for a total of 28 days.

Results

156 Plastic and Reconstructive Surgery (PRS) residency program leaders (RPL) were emailed. Response rate was 24% (38/156). 68% were division chiefs/chairs and 42% were program directors. 10% were both division chiefs/chairs and program directors. 78% were male. 87% of RPLs reported changes in number of away rotations, of which 91% reported less away rotations. Only 27% of programs provided virtual away rotations (VAR), and 88% of RPLs were not comfortable writing letters of recommendation after VARs. 100% reported that VARs influenced whether an applicant received an interview. 24 RPLs (63%) reported no changes how they viewed applications due to the pandemic. However, 5 (13%) reported USMLE scores were more important, 4 (11%) reported research more important, and 4 (11%) reported LORs more important. 66% did not feel they relied heavily on home institution candidates. 76% found virtual interviews effective in evaluating applicants and 71% reported they would add virtual interviews to future interview.

Conclusions

During 2020-2021 PRS residency application cycle, fewer away rotations were offered, and formerly in-person activities were moved to virtual platforms. Virtual activities caused difficulty assessing candidates for many residency programs.

COVID-19 and the Integrated Plastic Surgery Match: An Update on Match Trends by Applicant Location

COVID-19 significantly impacted the residency match process. Away rotations and in-person interviews were canceled in 2021, resulting in a geographic shift in integrated plastic surgery match results. Although several of these limitations were lifted during the 2022 cycle, the resulting geographic outcomes have yet to be described. This study aims to determine whether the changes seen during the previous cycle persisted despite loosened restrictions.

Optimizing the residency application process: insights from neurological surgery during the pandemic virtual application cycle

OBJECTIVE

In this article, the authors describe the impact of the COVID-19 virtual match cycle and discuss approaches to optimize future cycles through applicant and neurosurgical education leadership insights.

METHODS

Anonymous surveys of neurosurgery program leaders (program directors and program chairs), program administrators (PAs), and 2020-2021 neurosurgery residency match applicants were distributed by the SNS, in conjunction with the Association of Resident Administrators in Neurological Surgery and AANS Young Neurosurgeons Committee.

RESULTS

Responses were received from 77 (67.0%) of 115 PAs, 119 (51.7%) of 230 program leaders, and 124 (44.3%) of 280 applicants representing geographically diverse regions. During the virtual application cycle relative to the previous year, programs received more Electronic Residency Application Service applications (mean 314.8 vs 285.3, p < 0.0001) and conducted more applicant interviews (mean 45.2 vs 39.9, p = 0.0003). More than 50% of applicants applied to > 80 programs; 60.3% received ≤ 20 interview invitations, and 9% received > 40 invitations. Overall, 65% of applicants completed ≤ 20 interviews, whereas 34.7% completed > 20 interviews. Program leaders described one 4-week home subinternship (93.3%) and two 4-week external subinternships (68.9%) as optimal neurosurgical exposure; 62.8% of program leaders found the standardized letter of recommendation template to be somewhat (47.5%) or significantly (15.3%) helpful. Applicants, PAs, and program leaders all strongly preferred a hybrid model of in-person and virtual interview options for future application cycles over all in-person or all virtual options. Ninety-three percent of applicants reported matching within their top 10-ranked programs, and 52.9% of programs matched residents within the same decile ranking as in previous years.

CONCLUSIONS

Optimizing a national strategy for the neurosurgery application process that prioritizes equity and reduces costs, while ensuring adequate exposure for applicants to gain educational opportunities and evaluate programs, is critical to maintain a successful training system.

Impact of the Virtual Format on Plastic Surgery Residency and Fellowship Interviews: A National Cross-Sectional Study

BACKGROUND

The 2020-2021 residency and fellowship application cycles were profoundly affected by the introduction of virtual interviews (VIs). The authors investigate the impact that the virtual format (VF) had on plastic surgery residency and fellowship interviews from the perspectives of program directors (PDs).

METHODS

Surveys were sent to PDs of integrated plastic surgery residency (RPD) and fellowship (FPD) programs to ascertain their perspectives regarding the VF's impact on residency and fellowship interviews. PDs were stratified into residency and fellowship cohorts, and comparative analysis was performed.

RESULTS

A total of 92 PDs, 28 RPDs and 64 FPDs, completed our survey (35%). When compared to in-person interviews, VIs were reported to be more economical and time efficient by RPDs (100% and 46%, respectively) and FPDs (97% and 48%, respectively). Consequentially, 36% and 47% of residency and fellowship programs were able to interview more applicants, respectively. RPDs and FPDs reported that VIs hindered their ability to assess applicants' fit with the program (75% and 63%, respectively), personality and communication skills (75% and 64%, respectively), and commitment to the field along with their ability to function as a trainee (57% and 50%, respectively). Overall, 71% of RPDs and 58% of FPDs preferred in-person interviews. The majority of residency (71%) and fellowship (56%) programs intend to conduct both in-person and VIs in future application cycles (p=0.12).

CONCLUSIONS

Despite preferring in-person interviews, PDs intend on hosting both in-person and VIs in future application cycles. It remains to be seen how VIs will be employed moving forward.

LEGO®-based communication assessment in virtual general surgery residency interviews

Purpose

Effective communication skills are a critical quality and skill that is highly sought after for surgeons which largely impacts patient outcomes. Residency programs design their interview processes to select the best candidates. LEGO®-based activities have been frequently used to enhance communication skills and team building. This study investigates the effectiveness and reliability of a novel LEGO®-based communication assessment in interviews for surgical residencies and the feasibility of implementing it in a virtual setting.

Methods

This study conducted a retrospective analysis of a LEGO®-based communication assessment at the program's 2020/2021 residency interviews. Each applicant was assessed on a different model. The total scores were analyzed for consistency among raters and correlated to faculty interviews. Furthermore, the impact of the assessment structure, scoring criteria, and range of models' difficulties on the total scores were explored.

Results

A total of 54 categorical and 55 preliminary applicants interviewed on 2 days. The assessment on different models and had no impact on applicants' total scores for either categorical and preliminary groups (p = 0.791 and 0.709, respectively). The communication components of the assessment showed high consistency between the raters. The two applicant groups displayed a statistically significant difference (p = 0.004) in the communication evaluation and model accuracy components. Total scores did not correlate with the faculty interviews of standardized questions in either group.

Conclusion

This novel LEGO®-based communication assessment showed high reliability and promising results as a tool to assess communication and problem solving for residency interviews that can be readily implemented in a virtual setting.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44186-022-00021-4.

Impact of virtual vs. in-person interviews among neurosurgery residency applicants

BACKGROUND

The interview is considered a key factor in selecting residents in various medical and surgical specialties. However, the reliability of the interview process in selecting neurosurgery training program applicants remains largely under-investigated.

OBJECTIVE

To investigate the reliability of the interview process for neurosurgery residency applicants and to evaluate the impact of virtual interviews on this process.

METHODS

We analyzed the records of neurosurgery residency applicant interviews at our institution between 2016 and 2021. An average of 20 neurosurgery faculty members (clinical and research) interviewed each applicant and graded them 1 (best) to 4 (worst). Intraclass correlation coefficient (ICC) and Levene's test were used to assess the inter-rater and intra-rater reliability, respectively.

RESULTS

214 neurosurgery residency applicants were interviewed at a single institution between 2016 and 2021. The mean applicant rating each year ranged from 1.77 to 1.92. Inter-rater agreement was relatively poor in each year, (ICC < 0.5, P < 0.05). Among 60% of the raters, variability of scores significantly changed from year to year, (p < 0.05). When comparing the scores submitted during the virtual interview process (2021) with the scores submitted in the previous years (2016-2020), 2 interviewers (10%) had less variability using the virtual process.

CONCLUSION

Our analysis found that the current interview process for neurosurgery residency applicants' selection suffers from poor inter- and intra-rater reliability. Virtual interviews may be part of a cost-effective strategy to improve the reliability of the interview process. Further validation is needed, as well as identification of novel strategies to maximize the reliability of the selection process.

Virtual Interviews for Surgical Fellowship are an Acceptable Alternative to In-Person Interviews for Applicants and Faculty Alike

Background: In-person interviews have traditionally been an integral part of the fellowship application process to allow faculty and applicants to interact and evaluate the intangible aspects of the matching process. COVID-19 has forced a transition away from in-person interviews to a virtual platform. This study sought to track faculty and applicant perspectives on this transition. Study Design: Prospectively collected survey data was obtained from all participants after each of 3 consecutive virtual interview days for minimally invasive surgery fellowship at a single academic institution. Results: One hundred percent (27/27 applicants and 9/9 faculty) of interview participants completed the survey. Cost (100% applicants, 77.8% faculty) was perceived as the greatest barrier to in-person interviews, and “inability to get a feel for the program/applicant” was the largest concern for virtual interviews (66.7% applicants, 88.9% faculty). After interviews, most participants strongly agreed that they were able to assess education (66.7% applicants, 77.8% faculty), clinical experience (70.4% applicants, 77.8% faculty), and research potential (70.4% applicants, 88.9% faculty) through the virtual platform. Only 44.4% of each group strongly agreed that they could assess “overall fit” equally as well. Most faculty (6/9, 66.7%), but fewer applicants (10/27, 37.0%), were willing to completely eliminate in-person interviews. Conclusion: Virtual interviews may be an acceptable alternative to in-person interviews in times of COVID-19 and beyond. Offering a virtual format may help to eliminate costs associated with in-person visits while adequately assessing the fit of a program for both applicants and faculty, though applicants still desire an in-person option.

Effect of the COVID-19 pandemic on the residency match among surgical specialties

Background

Despite unprecedented changes to undergraduate medical education and the residency selection process during the COVID-19 pandemic, there is little objective evidence on how the pandemic affected match outcomes such as matched applicant characteristics, interview distribution, geographic clustering, and associated costs. We investigated COVID-19’s impact on the residency match by comparing surgery applicants’ characteristics, interview distribution, and related costs from 2018 to 2020 to 2021.

Methods

Data from the Texas Seeking Transparency in Applications to Residency initiative were analyzed. Descriptive statistics, bivariate testing, and sensitivity analysis were performed to compare matched applicants in surgical specialties from 2018–2020 to 2021.

Results

This study included 5,258 applicants who matched into 10 surgical specialties from 2018 to 2021. In 2021, there was a decrease in proportion of students who reported a geographic connection to their matched program (38.4% vs 42.1%; P = .021) and no significant difference in number of interviews attended (mean [SD], 13.1 [6.2] vs 13.3 [4.7]; P = .136) compared to prior years. Applicants in 2021 had more research experiences and fewer honored clerkships (both P < .001), and these associations persisted in sensitivity analysis. Matched applicants in 2021 reported significantly lower total costs associated with the residency application process compared to 2018 to 2020 (mean [SD] $1,959 [1,275] vs $6,756 [4,081]; P < .001).

Conclusion

Although COVID-19 appeared to result in a reduction in number of honored clerkships, it may have provided more opportunities for students to engage in research. Overall, the adoption of virtual interviews and away rotations may have successfully mitigated some of the adverse consequences of the pandemic on the residency match for surgical specialties.

Advocating for a New Residency Application Process: A Student Perspective

OBJECTIVE

The COVID-19 pandemic provided an opportunity for surgical residency programs to rethink their methods of evaluating and recruiting candidates. However, the past year has not been seamless, with a soaring number of applications, reports of programs and applicants having difficulty evaluating each other, and an increasingly uneven distribution of interviews among applicants. Consequently, many have called for national changes to the residency application process to address these longstanding concerns.

RESULTS

Here, we review the evolving literature and advocate for the permanent adoption of visiting rotations, virtual interviews with a universal release date and data-driven attendance limits, and opportunities for in-person applicant visits.

CONCLUSIONS

We believe these changes leverage the strengths of each format, allow for satisfactory bidirectional evaluation, and promote principles of justice, equity, diversity, and inclusion.

Implementation and evaluation of virtual multiple mini interviews as a selection tool for entry into paediatric postgraduate training: A Queensland experience

INTRODUCTION

The Queensland Basic Paediatric Training Network (QBPTN) is the centralised pathway for entry into paediatric training in Queensland, Australia. In response to COVID-19 travel and social distancing restrictions imposed in 2020, QBPTN successfully adopted a Virtual Multiple Mini Interviews (vMMIs) model for the selection of candidates for entry into paediatric training. The authors describe the planning, implementation, challenges, and evaluation of candidates' and interviewers' experiences of vMMIs, including the differences between candidates from two geographical areas.

METHODS

The contents of six vMMI stations were similar to face-to-face MMI. Implementation required the identification of ZOOM^TM as a preferred online platform, securing venues, communication, development of contingency plans and central coordination by the network. Candidates' experiences with vMMI were explored through thematic analysis of the qualitative data from focus groups and free text responses, and descriptive analysis of SurveyMonkey© questionnaire responses. Experiences between 'metropolitan' and 'regional and interstate' candidates were compared.

RESULTS

5-minute stations with 2-minute pre-reading were used. 78 candidates and 14 interviewers participated in the selection process. All candidates attended the focus group. 58.7% of candidates responded to post vMMI questionnaire. 93% of survey responders were happy to undertake vMMI in the future, with 23% feeling they would have performed better in face-to-face. Experiences between 'metropolitan' and 'other' groups were similar. Positive experiences of participants were related to the user-friendly IT platform, successful pre-interview communications, preparation, convenience, time, and cost savings. Stress related IT failures and difficulties establishing rapport with interviewers were reported as the main negative experiences.

CONCLUSION

'vMMI' is a feasible and acceptable method of selection into paediatric training. vMMI has many benefits and can be implemented relatively quickly by addressing key logistical requirements. The model under discussion could be adapted by other centres based on local needs.

The Experience of Virtual Interviews in Resident Selection: A Survey of Program Directors in Surgery

BACKGROUND

MATCH 2021 was short of the classic "in-person" component. Herein, we assess the impact of virtual interviews (VIs) on resident selection, from the perspectives of program directors (PDs) across all surgical specialties.

MATERIALS AND METHODS

We conducted a cross-sectional survey-based study of ACGME-accredited US residency program directors (PDs) of all surgical specialties. The survey was designed based on a review of relevant literature and inquired about the strengths, limitations, and overall utility of VIs.

RESULTS

A total of 365 PDs responded to our survey. Almost all respondents (90%) found VIs to be less expensive than in-person interviews, while only 34% agree that VIs were less time-consuming. Only a median of 5% of interviews was complicated by technical difficulties. Most PDs found it more challenging to assess applicants' fit (75%), personality and communication skills (71%), and commitment to specialty (60%). Only 14% found VIs to be overall better for assessing residency applicants. In future cycles, most PDs are planning to host both virtual and in-person interviews (57%), while 35% and 8% will host exclusive in-person and virtual interviews, respectively.

CONCLUSIONS

VIs are a novel way of dealing with the restrictions imposed by COVID-19. Despite their cost and time benefit, they present particular challenges in evaluating residency applicants. A combination of both virtual and in-person interviews will likely be implemented in the coming cycles.

Impact of the COVID-19 Pandemic on the 2021 Otolaryngology Residency Match: Analysis of the Texas STAR Database

Objectives/Hypothesis

To estimate the impact of the coronavirus disease 2019 (COVID‐19) pandemic on the 2021 otolaryngology match with regard to geographic clustering, interview distribution, applicant‐reported costs, and matched applicant characteristics.

Study Design

Retrospective cohort study.

Methods

Survey data from applicants to otolaryngology residency programs were obtained from the Texas Seeking Transparency in Applications to Residency database. Applicant differences between the 2021 match year and prior match years (2018, 2019, and 2020) were analyzed using two‐sided t‐tests, Chi‐square tests, and Fisher's exact tests.

Results

A total of 442 otolaryngology residency applicants responded to the survey, including 329 from the match years 2018 to 2020 and 113 from match year 2021. In 2021, 30.7% of responding applicants reported matching at a program where they had a geographic connection, compared to 40.0% in prior years (P = .139). Matched applicants in 2021 reported attending less interviews than applicants in prior years (mean 12.2 vs. 13.3, P = .040), and 26.1% of responding applicants reported matching at a program where they sent a preference signal. Applicants in the 2021 match reported significantly lower total costs than applicants in prior years (mean difference −$5,496, 95% confidence interval −$6,234 to −$4,759; P < .001). Compared to prior match years, matched applicants in 2021 had no meaningful differences in characteristics such as United States Medical Licensing Exam board scores, clerkship grades, honors society memberships, research output, volunteer experiences, or leadership experiences.

Conclusion

Based on this sample, there was no evidence of significant interview hoarding or increased geographic clustering in the 2021 otolaryngology match, and the COVID‐19 pandemic did not appear to result in significantly different matched applicant characteristics.

Level of Evidence

4 Laryngoscope, 132:1177–1183, 2022

The Virtual Interview Experience for MATCH 2021: A Pilot Survey of General Surgery Residency Program Directors

BACKGROUND

Virtual interviews (VIs) for the 2020 residency application season were mandated as a result of the COVID-19 pandemic. We aimed to determine the perspectives of general surgery (GS) program directors (PDs) on the benefits and drawbacks of VIs.

METHODS

A 14-item survey was emailed to all GS PDs from programs identified on the American Council for Graduate Medical Education website. Program directors were asked about the cost-time benefit of VIs, its ability to assess candidates, and their thoughts on the future of VIs for evaluating residency applicants.

RESULTS

60 PDs responded corresponding to a response rate of 21%. While 93% agreed/strongly agreed that VIs were less expensive, only 35% found VIs to be less time-consuming. 75% and 67%, respectively, disagreed/strongly disagreed that VIs allowed for an easier assessment of an applicant's fit, and personality and communication skills. Almost one-half of our survey respondents suggested that VIs made the selection committee rely more heavily on objective applicant data. Almost two-thirds of GS PDs suggested that they would adopt both VI and in-person interview formats for future application cycles. The median [interquartile range] cost saved through the implementation of VIs was US$ 4500 [1625 - 10 000].

CONCLUSION

Remarkably, VIs have been swiftly imbibed by all residency programs and many aspects of the VI experience were positive. While MATCH 2021 has definitely proved to be one of its kind, the implementation of VIs has been met with overall broad success and a promising future awaits this novel modality of resident selection to GME programs in the United States.

Perceptions of the Virtual Neurosurgery Application Cycle During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Program Director Survey

OBJECTIVE

The novel coronavirus disease 2019 (COVID-19) pandemic has led to a shift to virtual residency interviews for the 2020-2021 neurosurgery match, with unknown implications for stakeholders. This study seeks to analyze the perceptions of residency program directors (PDs) and associate program directors (APDs) regarding the current virtual format used for residency selection and interviews.

METHODS

An anonymous, 30-question survey was constructed and sent to 115 neurosurgery PDs and 26 APDs to assess respondent demographics, factors used to review applicants, perceptions of applicants and applicant engagement, perceptions of standardized letters and interview questions, the effect of the virtual interview format on various stakeholders, and the future outlook for the virtual residency interview format.

RESULTS

A total of 38 PDs and APDs completed this survey, constituting a response rate of 27.0%. Survey respondents received significantly more Electronic Residency Application Service applications in the 2020-2021 cycle compared with the 2019-2020 cycle (P = 0.0029). Subinternship performance by home-rotators, (26.3%), letters of recommendation (23.7%), and Step 1 score (18.4%) were ranked as the most important factors for evaluating candidates during the current virtual application cycle.

CONCLUSIONS

Our study highlights that applicants applied to a greater number of residency programs compared with years prior, that the criteria used by PDs/APDs to evaluate applicants remained largely consistent compared to previous years, and that the virtual residency interview format may disproportionately disadvantage Doctor of Osteopathic medicine and international medical graduate applicants. Further exploring attitudes toward signaling mechanisms and standardized letters may serve to inform changes to future neurosurgery match cycles.

Virtual Recruitment Is Here to Stay: A Survey of ID Fellowship Program Directors and Matched Applicants Regarding Their 2020 Virtual Recruitment Experiences

Background

Graduate Medical Education training programs transitioned to all-virtual recruitment in 2020. Limited data have been published regarding the consequences of this transition. We aimed to understand (1) infectious diseases (ID) fellowship programs’ recruitment efforts and the effect of virtual recruitment on application and interview numbers and (2) the number of programs to which matched applicants applied and interviewed and applicants’ perspectives on virtual recruitment.

Methods

In 2020–2021, we surveyed all US ID fellowship program directors (PDs) and matched applicants. Descriptive data analysis was performed on quantitative survey items. Free-text responses were analyzed through a quantitative content analysis approach.

Results

The PD response rate was 68/158 (43%); the applicant response rate was at least 23% (85/365). PDs reported a 27% increase in mean number of applications received and a 45% increase in mean number of applicants interviewed compared with the previous year. Applicants especially valued the online program structure information, PD program overview videos, didactic and curriculum content, and fellow testimonials and profiles. Most applicants preferred interviews lasting no more than 40 minutes and interview days lasting no more than 5 hours. Nearly all (60/64, 94%) PDs adequately learned about candidates; most (48/64, 75%) felt unable to showcase their program as well as when in-person. Most PDs (54/64, 84%) and applicants (56/73, 77%) want an option for virtual recruitment.

Conclusions

Virtual recruitment enabled programs to accommodate more applicants and highlighted applicants’ preferences for programs’ augmented online presences and time-limited interview days. Most programs and applicants want an option for virtual interviews.

Doctority: Plastic Surgery-An Informative Podcast for Applicants to Learn about Plastic Surgery Training Programs

The COVID-19 pandemic limited the ability of medical students to participate in plastic surgery sub-internships and to attend residency interviews in person during the 2020–2021 match cycle. A podcast and accompanying online directory were created to introduce integrated plastic surgery residency programs to medical students from the perspective of current residents. Since July 2020, a total of 49 plastic surgery residents representing 42 programs have participated in the podcast. Topics of discussion included program logistics, faculty leadership, and aspects of resident lifestyle of interest to medical students and future residency candidates. The podcast has had a total of 5072 downloads (mean 121 downloads per episode). The majority of listeners (90%) were in the United States. Twenty-five plastic surgery applicants who participated in the 2020–2021 National Resident Matching Program match cycle responded to a feedback survey. Listeners reported that the podcast was useful for preparing for interviews, making rank lists, and learning about programs that they otherwise would not have considered. Most listeners (90%) ranked the podcast as one of their top three resources for learning about plastic surgery programs during the application and interview process. Future directions include completion of episodes for all integrated plastic surgery programs and expansion to other surgical subspecialties and plastic surgery fellowships.

Effect of COVID-19 on Geographic Distribution of the Integrated Plastic Surgery Match

Background:

COVID-19 had significant impact on the 2021 integrated plastic surgery match, most notably through cancellation of away rotations and virtual interviews. While previous studies have analyzed geographic outcomes of the match in prior years, the effects of COVID-19 have not been determined. This study aims to contribute 2021 match data to determine the effects of COVID-19 on the geographic distribution of the integrated plastic surgery match.

Methods:

Official match results for each program were populated by searching official program institutional websites and social media pages. Trainees’ home medical institutions and current integrated plastic surgery residency programs were noted. Statistical analysis compared geographic distribution in COVID-19 affected (2021) and non-COVID-19 affected (2015-2020) match years.

Results:

Of 85 integrated plastic surgery programs, 80% (n = 68) of programs and 1,015 matched trainees were included in this study. The average percentage of institutional matches in COVID-19-affected match year was 25.12%, compared to 16.67% for non-COVID-19-affected match years (p = 0.0012). The odds ratio of matching at a home institution in 2021 compared to prior years was 1.68 (95% CI 1.11-2.53).

Conclusions:

Our study is consistent with previous studies that demonstrate strong match preferences for affiliated medical students but also adds that this trend may be amplified in the post-COVID-19 era. While multiple factors may be involved in geographic distributions of residency match outcomes, the results of this study suggest that COVID-19 restrictions on travel and exposure to outside programs may have contributed to an even higher percentage of matches within the same institution.