COVID-19 changed many things in the past year, including how otolaryngology residency programs and applicants interviewed for the National Residency Matching Program.
Conditions overall weren’t ideal for residency programs deciding who would be their best residents for the next five years—visiting rotations were suspended and in-person meetings moved to virtual platforms. Due to personal protective equipment (PPE) shortages, some programs weren’t even allowed to have away rotators during the 2020-21 Match season, even if they were from a medical school without a home otolaryngology program.
“Our ability to get to know applicants was seen as a significant challenge,” said Steven D. Pletcher, MD, director of the residency program in the department of otolaryngology at the University of California, San Francisco (UCSF), and an Otolaryngology Program Directors Organization (OPDO) council member. Dr. Pletcher added that this year it was much more challenging to provide applicants with a sense of the culture of his program as well as the day-to-day experience of living in San Francisco.
Programs Got Creative
Still, many residency programs went the extra mile to give applicants the best opportunity to get to know the program and its particulars. Programs held virtual information sessions, created residency videos, breathed new life into department websites, and launched social media accounts—primarily on Twitter and Instagram—in the hope of providing applicants with a good sense of the nuts and bolts of their programs as well as the vibe among their faculty and residents.
“One of the biggest issues for us was trying to figure out how to let the students know the subtleties and the character of our program if they’re not physically there to see it,” said Stacey T. Gray, MD, associate professor and residency program director at Harvard Medical School in Boston.
Harvard held webinar-type presentations for prospective student applicants. Dr. Gray said doing this virtually meant Harvard could reach a wider audience. Among other topics, these webinars covered basic program details, resident life (this section was run by residents), and research opportunities within residency, since Harvard has a seven-year research track program.
“That isn’t something we had ever done before,” Dr. Gray said. “But we were able to allow students to ask questions of faculty, and often several hundred prospective students attended these presentations. I think before they were even applying, students may have had more information about programs than they ever would have had in a normal year.”
At resident interview time, the University of Colorado School of Medicine in Aurora sent out information sheets to the residents and faculty with each applicant’s hometown, medical school, and listed hobbies so residents and faculty interacting with the interviewees would have a starting point for conversations. To add an even more personal touch, Cristina Cabrera-Muffly, MD, associate professor and residency program director in the department of otolaryngology at the University of Colorado School of Medicine in Denver, assigned each resident three to four interviewed applicants to call or email after the interview to answer follow-up questions.
Dr. Pletcher said that because the virtual interview process was new for his department, they leaned on advice from their fellowship programs. These programs had already been through a virtual process and used institutional best practices to create a meaningful experience for applicants, while providing faculty the ability to assess applicants’ interpersonal skills. The UCSF program was also creative, using a new virtual platform called Varty for its post-interview social event. Varty creates a casual virtual environment that looks like a party, where people can chat on virtual sofas in small groups.
Dr. Cabrera-Muffly’s program hosted a virtual social hour with a fun twist on the night before each interview day. “Each applicant received a care package with taco seasoning mix, a package of margarita mix that could be used with alcohol or water, and some CU swag so they could participate in a taco party while socializing in small groups.” The program received excellent feedback on this event.
Tech Anxiety and Zoom Interviews
While some faculty anticipated technology-related mishaps, most were pleasantly surprised and said the process went smoothly. Dr. Cabrera-Muffly credits the efforts of the University of Colorado program coordinator and a pre-interview tech meeting with all interviewers that was meant to anticipate glitches.
And, as the pandemic wore on, people just generally began mastering the art of videoconferencing. “By mid to late fall, the students and faculty were already comfortable and adept at videoconferencing, so the logistical efforts of interviewing were straightforward,” said Sonya Malekzadeh, MD, professor and residency program director of otolaryngology at Georgetown University Medical Center in Washington, D.C. “Academic departments, residency programs, and student applicants were all able to pivot and rethink the traditional paradigms,” she said. “Innovative virtual events and social media efforts were successful alternatives to in-person experiences.” Dr. Malekzadeh believes that, thanks to their ease of use, some form of virtual recruitment sessions and interviews may be here to stay.
One of the biggest issues for us was trying to figure out how to let the students know the subtleties and the character of our program if they’re not physically there to see it. —Stacey T. Gray, MD
For medical students, the biggest advantages of virtual interviews were largely socioeconomic. Emma Martin, MD, a first-year otolaryngology resident at the University of Illinois Hospital and Health Sciences in Chicago, said that virtual interviews can level the playing field for students who don’t have unlimited financial resources.
“In the past, I think candidates with a large number of offers were somewhat limited by how many hotel stays and round-trip plane tickets they were able to purchase in addition to the other expenses that come with traveling,” she said. “I think it helps eliminate those disparities to make interviews virtual.” She added that, generally, applicants this year received about as many interviews as they would have in any other year, so she wasn’t sure how much of a difference the pandemic actually made in that regard.
Virtual interviews did allow for a student who was offered interviews on the same date at different times in different states to attend both. When Dr. Martin was interviewing, she had to turn down several opportunities because they conflicted with dates she had already set for a different interview. “Even if one was in the morning and the other was in the afternoon on the same day, physically I couldn’t teleport from one place to another,” she said. “But, virtually, I could have logged off of one, had an hour or so break, and then logged on to the other.”
There was a downside to the fact that virtual interviews literally didn’t cost medical students a dime, however. Early on, Dr. Gray said, the Association of American Medical Colleges sent an email alerting programs about their concern that some students might take as many interviews as they were offered, a problem that could happen across the board, not just for otolaryngology.
“There was a lot of talk about interview hoarding,” said Shadi Mehrabi, MD, who matched this year in otolaryngology at the University of Michigan Medical School in Ann Arbor. “People who are rock stars on paper could just go to as many interviews as they wanted. And there would be no self-limiting thing, like traveling and coordinating being on the West Coast one day and the East Coast the next day.” There was also concern that interview hoarding would lead to unmatched spots, although that didn’t happen, possibly due to the record number of applicants in the cycle this year.
Another downside to virtual interviews for medical students was missing out on the in-person interaction and social cues that would let them know a particular institution was “their place” and that these were “their people.” “Every program can say, ‘We’re the best. We’re incredible. We all get along and we love each other so much,’” said Corinne Pittman, MD, who matched this year in otolaryngology at Georgetown University in Washington, D.C. “But is that really true? It’s harder to get a feel for that when you’re not interacting face to face in person.” For some students, virtual-only interviews also meant choosing a city to live in for the next five to seven years that they had never even visited.
Changes That May Stick
Although this year was an outlier, many physicians felt that some of the changes that were made to the Match process to accommodate the global pandemic may stay around for more than just one year.
Dr. Pletcher called this Match an interesting natural experiment that could provide insight into the actual impact of changing to a virtual format.
Dr. Cabrera-Muffly thinks extensive website updates are here to stay. And while her preference is to return to in-person interviews, she now plans to send out info sheets to faculty and residents every year to facilitate interactions.
Dr. Gray believes virtual outreach will continue, including webinars, because the students have really seemed to enjoy it.
And, despite the stresses and challenges of interviewing applicants virtually during a pandemic, Dr. Martin said her program ended up matching with three excellent candidates who were very enthusiastic about coming to the University of Illinois in Chicago. One was a home student who had done a rotation with them, but the others had not—they had simply been impressed and excited by their interview day.
“I think it’s hard to say that virtual interviews don’t work or aren’t as good as in-person interviews when you get the results that came out of the Match this year,” Dr. Martin said. “I think a lot of the people are extremely happy with where they matched. It seems comparable to past years when everything was in person.”
Renée Bacher is a freelance medical writer based in Louisiana.