Match2021: Virtual Residency Interviews

PERSPECTIVES

#MATCH2021: VIRTUAL RESIDENCY INTERVIEWS

By Addie Burtle, MD; Stephanie Cortes, MD, MS, MA; Reba Gillis, MD, MBS; and Al’ai Alvarez, MD on behalf of the SAEM Clerkship Directors in Emergency Medicine Academy and Academy for Diversity and Inclusion in Emergency Medicine, and Equity and Inclusion Committee

Residency recruitment requires significant time and financial investments for students. It took a pandemic to change our recruitment practices in medicine, forcing the first large-scale experiment on virtual interviewing feasibility. Further, the murders of George Floyd, Breonna Taylor, and several others during the pandemic reignited national attention to the need for addressing structural racism and inequities, including within health care. In turn, diversity, equity, and inclusion became an even bigger priority for residency programs during the pandemic.

According to the Coalition on Physician Accountability (CoPA), all interviews for the #Match2022 will be virtual. CoPA also recommends an “ongoing study on the impact and benefits of virtual interviewing as a permanent means of interviewing for residency.”

Several underrepresented trainees in medicine (UiM) who successfully Matched in EM in 2021 share their reflections on their virtual interview experience.

PRO: Cost Savings

Traveling for interviews costs the average student several thousands of dollars to cover transportation, hotels, and food in a new city. Data from the AAMC and others suggest that more than half of applicants limit their interviewing due to the financial burden. Students of lower socioeconomic status, and those from geographically isolated regions, are more likely affected. Unfortunately, these students may also be the least

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able to afford the risk of declining interviews due to their intersectional identities as underrepresented in medicine (UiM). Virtual interviews allowed students to focus on more critical factors when deciding where to apply and interview, thus creating a better playing field for all applicants.

“It saved me a lot of money and stress. I didn’t have to worry about scheduling a flight/hotel/rental car. I didn’t have to worry about adding to my loan burden. I didn’t have to worry about where I would be getting this money from if loans didn’t cover my expenses. I also saved money on interview clothes.”

“The cost of setting up my background with ring lights, a camera, and a microphone is a lot less than the price of traveling and staying in a different state.”

PRO: Increased Number and Geographic Opportunities to Apply

The extra funds saved by doing virtual interviews allowed those who might not have had the most competitive academic portfolio to apply to additional programs, increasing their chances of matching. The savings also allowed candidates to expand the breadth of their geographic search and to explore programs beyond certain proximity.

“Without the need to travel, I was able to have interviews in different states in the same week. I could interview with a program in CA one day, and then interview in NY the next day.”

PRO: Easier to Schedule Virtually

A significant benefit for candidates was the ease of scheduling across different programs because several critical travel logistics were no longer needed. Students were better able to balance their rotation requirements and other curricular commitments with interviews, despite disruptions due to the pandemic.

“I learned some important organizational skills navigating and balancing multiple residency program events.”

PRO: Time Savings

Forgoing travel allowed candidates to focus their time on interview preparation instead of worrying about flight disruptions, inclement weather, and scheduling interviews during their clinical rotations.

“Interview days were shorter. Because I did not have to travel, most interviews were between 4-6 hours long.”

PRO: Convenience and More Time to Prepare

Since interviews were done from the comforts of one’s home, the interview experience was more relaxed. Instead of stressing over traffic and flight delays, candidates spent their time reviewing their application material and notes about programs.

“The small breaks allowed me to walk around my apartment to grab some coffee/food and prepare for my next interview without feeling like I’m “on” for the whole interview. I even had my pets around so I could just pick them up and show the interviewer.”

PRO: Better Access to Faculty and Residents for Networking

The virtual space allowed programs to be more creative with how candidates would interact with them. Virtual social events and faculty office hours offered more diversity of interactions. Faculty and residents only needed to log on for a fraction of the time instead of blocking bigger chunks of their day as would have been necessary during in-person interview events.

“I was able to meet so many faculty and residents virtually, and I hope to maintain those relationships despite not matching at those institutions.”

CON: It’s Not the Same

The virtual platform made it challenging for candidates to truly experience the sights, sounds, and smells of the program. Because of the interview schedule structure, there was limited time to have more candid conversations since everyone was always “on” camera.

“I couldn’t really see the environment I would be exposed to during residency.”

“Social events didn’t seem very personal. The interviewees to residents/faculty ratio were skewed heavily towards applicants, which did not allow for direct, one-on-one interactions.”

“Interviews with faculty sometimes felt rushed.”

CON: IT Issues

Because this platform was new for most, unanticipated bandwidth issues and technological glitches were common.

“My microphone didn’t work during one of my interviews, and I had to call each interviewer individually.”

“The internet went out once hours before the interview, and I had to call the internet company to help fix it; otherwise, I would have had to reschedule.”

CON: Zoom Fatigue

Unlike in-person interviews, where candidates must physically move from one room to another, staring at the same screen for four hours was draining.

CON: Lack of Standardization

Because last year was the first year for programs to adapt to the virtual interview platform, standardization across programs was difficult. Programs had variable pre-interview social events, swag, and schedules. Some offered lunch breaks with residents; some did not. Interview length varied from short interviews to all-day events. Availability of information regarding salary, benefits, and residency life varied. This made comparing programs objectively challenging for candidates.

CON: New Forms of Bias

While virtual interviews offer an even playing field regarding cost and availability, new forms of inequity existed, including variable access to better audio-video equipment, better lighting, staging, a quiet room, faster internet, and even hoarding of interview spots. Many virtual backgrounds may also not work well with certain skin tones and hairstyles. Furthermore, while many welcomed the chance to offer a glimpse into their homes as a way of humanizing and personalizing themselves, the lack of standardization also had the potential to magnify implicit bias. ABOUT THE AUTHORS:

Dr. Burtle is a PGY-1, Washington University in St. Louis Emergency Medicine Residency, @SocialMeasures

Dr. Cortes is a PGY-1, Indiana University Emergency Medicine Residency @Stephanie_C21

Dr. Gillis is PGY-1, Yale-New Haven Emergency Medicine Residency, @RPG_MD21

Dr. Alvarez is the director of Well-Being, Stanford Emergency Medicine, @alvarezzzy

Virtual Interviews for the Win!

Overall, universally requiring virtual interviews offered several wins for the candidates. While there are drawbacks to virtual recruitment, these can be opportunities for programs to improve for the upcoming interview season. As the pandemic continues, it is reassuring to know that EM-bound candidates will not have to worry about traveling for their interviews this year. With enough planning and preparation, we can help future EM physicians succeed in “The Match.” As we move toward a more inclusive recruitment cycle, hopefully someday we can find the right balance between individualized and standardized recruitment experiences.