How COVID-19 changed our fellowship interview process for the better


The COVID-19 pandemic is fundamentally changing medical practice across the country by allowing telemedicine reimbursement, where it was previously limited, and by leveraging video conferencing technology to conduct business and educational meetings in order to comply with social distancing guidance. Necessity is resulting in innovative ways to interact with patients, colleagues, and now with prospective trainees as residency and fellowship interview season begins. While in-person interviews are a trademark of past interview seasons, moving forward, we have the opportunity to capitalize on the procedural changes necessitated by social distancing by fundamentally changing the residency and fellowship interview process moving forward.

This week, we conducted our first fellowship interviews by group video chat in order to respect travel restrictions and social distancing guidance due to the COVID-19 pandemic. While the experience took a little getting used to, it was not dissimilar to an actual interview environment. Besides the clear necessity to limit travel in the midst of this global crisis, other benefits to this process were immediately apparent: 1) reduced financial burden for candidates by eliminating the cost of travel and 2) reduced strain on the medical system by not having trainees out of work for the additional travel days required to interview.

In 2019, 38,376 applicants actively participated in the National Residency Matching Program. The median number of interviews attended by U.S. seniors who matched into residency was 13. Multiplying these numbers by the cost of airfare, ground transportation, meals, and accommodations amounts to a significant burden on trainees. Widely adopting online video interviews will have major positive effects economically for trainees and environmentally as we reduce unnecessary cross country travel.

Instead of students and residents traveling the country in crisscrossing caravans, they would interview online from their own homes or institutions. These changes would limit the number of days away from work or school and eliminate the costs and environmental impact of travel. Without the additional financial burden of travel, applicants may also have an opportunity to interview more broadly, thus providing a more equitable interview process for candidates with fewer funds. Furthermore, programs would benefit from the increased flexibility in scheduling. Smaller programs in less accessible locations would have an equal playing field with larger institutions in urban centers.  Moreover, eliminating the needed travel time between interviews, programs would be less likely to have conflicting interview schedules which could allow for a larger pool of interviewees.

Some may argue that video interviews are not feasible because seeing a program in person is essential to the decision to rank a program highly, however, the opportunity for candidates to see a program in person could still exist without influencing program ranking decisions by staggering the rank list submission. In this model, programs could submit a rank list as soon as their video interviews were completed. With rank lists finalized, candidates could then choose travel to visit programs prior to submitting their own rank list.

The historically physically and financially exhausting interview season can be fundamentally changed for the better by adopting online video interviews universally. We have a unique opportunity to dramatically improve the graduate medical education interview process through no-travel video interviews. As we embark on trainee interview season in the midst of the COVID-19 pandemic, I encourage all program directors to evaluate the innovative video conferencing technology and consider broad implementation in years to come.

Aparajit Naram is a plastic surgeon.

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