Explaining a Potential Interview Match for Graduate Medical Education

Interview Without Harm: Reimagining Medical Training's Financially and Environmentally Costly Interview Practices

The looming threat of climate change urgently calls for reimagining unsustainable systems and practices, including academia's culture of emissions-intensive travel. Given that medical educators are uniquely invested in the future of the trainees they represent, this reimagination can and should begin with medical education. Making significant reforms to the application process has historically been challenging, but the COVID-19 pandemic catalyzed an abrupt shift from in-person to virtual interviews for medical school, residency, and fellowship. Programs and applicants alike demonstrated resilience, innovation, and satisfaction in adapting to virtual interviews during 2 full application cycles. This restructuring has prompted consideration of the necessity of environmentally costly, expensive, and time-consuming cross-country travel for single-day interviews. However, evolving conversations about the future of medical training interviews have not prioritized environmental impact, despite the sizeable historical emissions generated by interview-related travel and the incompatibility between ecological damage and population health. Beyond environmental impact, virtual interviews are more equitable, with significantly fewer financial costs, and they are more efficient, requiring less time off from school or work. Many concerns associated with virtual interviews, including interview inflation and limited applicant exposure to programs and their surrounding areas, can be addressed via creative and structural solutions, such as interview caps and in-person second-look programs. The medical training interview process underwent a forced restructuring due to the unprecedented disruption caused by COVID-19. This moment presents a strategic inflection point for medical education leadership to build on the momentum and permanently transform the process by focusing on sustainability and equity.

Characterization of Applicant Preference Signals, Invitations for Interviews, and Inclusion on Match Lists for Residency Positions in Urology

Importance

Preference signals were to be implemented in over 15 specialties during the 2022-2023 residency match. Analyzing results from the implementation of signals during the American Urological Association (AUA) urology match may inform future behavior.

Objective

To characterize applicant and program signal usage and results in the Society of Academic Urology and AUA databases with respect to interview invites and rank list creation.

Design, Setting, and Participants

This cohort study involved all applicants and residencies in the 2021-2022 AUA match with data analysis conducted in April through July 2022.

Exposures

Five signals indicating interest.

Main Outcomes and Measures

Using verified match and survey data reported by applicants and programs, a logistic regression was performed on applicant factors associated with obtaining an interview-the main outcome (using inclusion on rank list as a proxy): age, gender, degree (MD or DO), dispersal of signal, US senior status, racial minority group status, Latino ethnicity, international medical graduate status, presence of a home program, AUA geographic section, and US Medical Licensing Examination Step 1 score. Applicant signal dispersal strategies were stratified by applicant and program competitiveness, as well as program behavior upon receipt of signal with respect to extending interviews and rank list ordering of applicants.

Results

A total of 2659 signals were sent by 553 candidates (mean [SD] age, 27.4 [2.9] years; 179 female [32.4%], 243 racial minority candidates [61.2%]) submitting rank lists for 364 positions at 143 programs. Programs received a median (IQR) of 352 (295-411) applications and were signaled to a median of 16 (8-26) times each. In a logistic regression estimating interview status, geographic proximity (OR, 3.25; 95% CI, 2.05-5.15; P = .001) and signal status (OR, 6.04; 95% CI, 3.50-10.40; P < .001) were associated with receiving an interview. Using multiple imputation by chained equations to impute missing data and broadening the data set, male gender (OR, 0.64; 95% CI, 0.45-0.92; P = .04) and international medical graduate status (OR, 0.35; 95% CI, 0.15-0.81; P = .04) were negative variables, while MD degree (OR, 2.36; 95% CI, 1.27-4.36; P = .02) and US senior status (OR, 1.91; 95% CI, 1.13-3.23; P = .04) were positive variables.

Conclusions and Relevance

This study of the usage and trends of the newly added preference signals reported the most common strategies for signal dispersal; in an analysis of factors involved in obtaining an interview, geographic similarity between applicant and program and preference signal usage were associated with successful applications.

Designing the "match of the future": challenges and proposed solutions in the interview and match phase of the UME-GME transition

This review focuses on the interview and match process with the purpose of broadly reviewing challenges in the current surgical residency selection process, detailing potential solutions, and identifying future avenues of investigation.

Preference Signaling in the 2022 Urology Residency Match - The Applicant Perspective

OBJECTIVE

To evaluate the applicant experience with preference signaling during the 2022 Urology Residency Match.

METHODS

An anonymous electronic survey was emailed to all urology residency applicants who applied to Rutgers Robert Wood Johnson Medical School (RWJMS) during the 2021-2022 application cycle. The survey collected information regarding applicant demographics, applicant characteristics, preference signal destinations, match outcomes, and attitude towards preference signaling.

RESULTS

A total of 601 applicants applied to the 2022 Urology Residency Match, 283 of which applied to the urology residency program at RWJMS. Of the 283 applicants, 53 (19%) responded to our survey. Rate of interview for preference signaled programs was 54.23%, with a significantly lower rate of interview for comparative, non-signaled programs (40.54%; p = 0.001). Of respondents, 14.29%, 26.19%, and 35.71% matched to their home program, a program they signaled, or a program where they completed an away rotation, respectively. 96% of applicants favored continuation of the preference signaling program.

CONCLUSIONS

Our study suggests preference signaling in the 2022 Urology Match may have been an effective method of expressing interest in a program. Respondents of our survey overwhelmingly favor continuation of the program in future urology matches. However, it may not address the underlying, growing problem of the increasing application burden on applicants and programs alike. We encourage more comprehensive studies to further clarify the effects of preference signaling on the Urology Match.