The COVID-19 pandemic has put many things on pause, but medical school marches on to a graduation date, same as always. This has left residency programs and fourth-year medical students to figure out how to execute the process of interviewing for residency matches in a virtual format. Like many things this year, this process is unprecedented, so no one knew what to expect going in. After speaking with some medical students currently in the interview process, I was able to gain some insight into the pros and cons of this new system.

Starting with the more negative aspects, the interviewees I spoke with feel mentally exhausted and physically drained after a day of interviews. For the greater portion of the day, they have stared at their computer screen with a ring light shining in their eyes. Sitting and staring into the screen all day can take a toll on your body, and some feel even more exhausted after this than after a day of in-person interviews. In addition, the potential for technical difficulties is always a concern, though thankfully they do not occur often.

Beyond the bright lights and fear of technological failure, there are missed opportunities for the casual social interactions that would occur with an in-person interview. In a normal interview season, there would be many chances for private, one-on-one conversations with current residents. This year, interviewees have lost the opportunity to get a good sense of the residency program culture in this way or to ask more personal questions they may not want to ask in front of a group. Most residents will say they love the culture of their program when asked on a Zoom call, but it’s hard to truly judge this aspect through the internet. Therefore, interviewees overall feel the interview process has been fairly one-dimensional.

Applicants also miss the opportunity to get a feel for the cities that their potential residency programs are in, as well as the hospitals through which they are run. Programs have been attempting to compile videos and presentations showcasing what their cities have to offer, as well as what the interiors of their hospitals are like. To some applicants, this may not be important, but to others, the location is a critical part of their decision-making process. For these students, being unable to visit the location where they may spend the next several years of their life complicates their decision greatly. “I can imagine talking to faculty, meeting patients, walking the halls of the hospital and seeing the culture of the city would make one much more excited about the potential of moving to a place, or may enlighten you that it isn’t the best fit for you,” says one fourth-year student currently going through the process.

Another challenge that residency applicants face this year is “interview hoarding.” Data from the National Residency Matching Program (NRMP) show that in years past, applicants typically need eight to 12 interviews to have a 90%–95% chance of matching, depending on the competitiveness of the specialty. However, since travel is not a factor this interview season, many applicants are applying to more programs and accepting more interviews than they would in a typical application season. This leaves low- to mid-competitive range applicants without a safe number of interviews to rank at the end of the season due to top applicants being offered and accepting an unusually high number of interviews. Going into this application cycle, no one was sure what would happen, so mentors were not able to confidently advise students on how many applications to complete. Now that the issue is becoming more apparent, students going through the process and program administrators of more competitive specialties are encouraging applicants to only accept 12–15 interviews to level the playing field and give more applicants a chance to match.

Though there are many downsides to virtual interviewing, there are some bright spots as well. The biggest positive aspect is the huge amount of money being saved by applicants. Normally, applicants pay out of pocket for flights, hotels and travel-related expenses during interview season. For couples matching, even more interviews may be required, and it can be even more costly — some reporting upward of $30,000 spent. Not having to pay for these expenses is life-changing for some applicants, and for that they are grateful. One student who is couples matching noted, “[Normally] If I went on an earlier interview somewhere not knowing if my partner would get [an interview at the same school] later and they got rejected, I not only would have wasted time but also travel money.” Logistically, the virtual format makes things easier, too. Time is saved that would have been spent trying to figure out travel logistics and trying to work out getting from place to place in time for the next interview. Now, one can have an interview on the east coast one day and the west coast the next, and it is not an issue. Students have also noted that it is easier to juggle other responsibilities of medical school, such as clinical electives and studying for the USMLE Step 2 exam, while interviewing from home.

So, this raises the question, should the virtual format remain an option after the pandemic has subsided? Despite the positive aspects, mainly monetary savings, of virtual interviewing, most students agree that they would opt for in-person interviewing if they were given the choice and COVID-19 was not a factor. In years to come, perhaps residency programs could implement an optional virtual interview format to accommodate all applicants so that cost is not a barrier. The NRMP could also limit the number of virtual interviews that applicants could accept to avoid the tempting convenience of interview hoarding. Though this application season has been a stressful experience for many, everyone is trying their best to make the most of it. In the end, we can all hope that lessons learned will be applied to future cycles, for in-person and virtual interviews alike.

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