Making the most of virtual interviews with surgical training programs

The coronavirus (COVID-19) pandemic has had a profound impact on the medical field, with far-reaching and practice-altering effects on health science education.^1-3 Amid social distancing constraints and the necessity to ensure sound postgraduate training, we have witnessed the inexorable rise of digital communication platforms as a powerful bridge to interconnectivity.

Virtual conferencing and interviewing wove itself into the fabric of our daily interactions with patients and colleagues alike.⁴ As a new fellowship and residency application season approaches, senior medical students and residents must grapple with the new reality of virtual fellowship and residency interviews. From a trainee’s perspective, this new format’s benefits are substantial, including reduced costs, reduced time away from clinical duties, and the ability to extend the number of prospective programs.^5-7

Mitigating these potential benefits, however, are concerns that the loss of in-person social interactions with programs may preclude the effective projection of the candidate’s personality and attributes or interfere with the accurate assessment of a program’s culture. Although the surgical literature indicates an interest in the impact of virtual interviews, no consensus exists on best practices. This article, written by members of the Resident Associate Society of the American College of Surgeons (RAS-ACS) Communications Committee, explores how surgical trainees and medical students can use this digital platform to their advantage.

Traditional versus virtual interviews

Fourth-year medical students go through an average of 12.3 residency interviews, and 65.7 percent spend $1,000 to $5,000 on travel and accommodations for these opportunities, with 19.5 percent of surgery applicants spending more than $7,000.⁸ More specifically, a study by Fried and colleagues noted that medical students spent an average of $3,422.71 on interviews.⁵ Up to 79 percent of fourth-year medical students felt burdened by travel expenses for interviews.⁵

Another study showed that residents travel up to 2,737.98 miles and spend, on average, $4,995.23 on fellowship interviews. In addition, traveling to these interviews can require missing up to 20 days from medical education.⁶ Tseng and colleagues showed that candidates for surgical fellowship spent an average of $5,000 to $15,000 on interview-related expenses.⁷

For most trainees and medical students, web-based interview platforms provide a more convenient and cost-effective option than in-person interviews.⁸ Virtual interviews can be live, with the interviewer and applicant sitting face-to-face at computers, or on-demand, with applicants responding to video-recorded questions uploaded with the application.⁹

Despite these advantages, a recent survey of medical students and residents indicates a preference for in-person interviews, even though both groups agree that virtual interviews should be offered as an option during the COVID-19 pandemic.¹⁰ It appears that the efficiency provided by virtual interviews must outweigh the in-person social connections afforded by face-to-face interviews for candidates who prefer digital options.¹⁰ Applicants continue to want to experience the feel of the program and the city where they potentially will be training and living for the next few years.¹¹

In addition, up to 15 percent of residents in one study reported that they did not have an adequate opportunity to portray themselves in videoconference interviews.¹¹ Despite these reservations, the ongoing pandemic indicates that virtual interviews are here for the foreseeable future.

A recent survey conducted by the RAS and the Young Fellows Association of the ACS demonstrated that more than half of respondents in the last year experienced disruption of interviews because of the COVID-19 pandemic.¹² With at least one application season under the belt, programs and candidates alike are exploring tools to enhance the human interaction experience during virtual interviews.

Making the most of virtual interviews

Before starting the interview season, it may be worthwhile to visit the ACS Division of Education web page and review the material on applying to residency at www.facs.org/education/resources/medical-students. The guide is tailored toward medical students and in-person interviews, but many of the suggestions are applicable to fellowship interviews as well. In particular, the section on navigating the application process may be useful for both residents and medical students.¹³

When applying to these programs, plan out the interview season. Without traveling, applicants most likely can interview at more places. Likewise, programs probably are interviewing more candidates. Determine how many interviews are needed to match. It is unclear how virtual interviews will affect the fellowship or residency match and recruitment, and it is easy to overapply. Furthermore, the interviews themselves are time-consuming and tiring. Finding the right balance of enough interviews to match and not using an entire year’s time and days off interviewing is vital.

Before the first interview invitation, take some time to configure your environment for the interviews. The most common places people interview are at home or in a call room at work. Make sure that your Internet connection is adequate and reliable, or you may find yourself changing locations during the interview day, which can add unnecessary stress. Make certain that the location has enough outlets to charge your laptop and adequate lighting. Because interviews all start at different times, it is worth the effort to identify several sites, particularly if you plan on doing interviews at work in a conference or call room. Not having a backup may leave you panicking if your planned location is in use on the day of the interview.

Before each interview, make sure you know which interview program (or programs) the institution is using. Most institutions use a single program for interviews but a separate vendor for conferences because of institutional or legal requirements. Others use the same program for conferences and interviews. Make sure that all programs to be used are downloaded and installed before the interview and that you are familiar with the features of the system. It is significantly more challenging to carry on a conversation via videoconference than in person, and a lack of familiarity with the system will only make it more difficult.

On the day of the interview, grab a quick breakfast and get set up. Despite the camera capturing what you want it to capture, it may be challenging to get into the interview mindset wearing scrub pants with a suit jacket. Ensure the lighting is set up so that you are visible and the camera captures you from the waist up. Perhaps the only thing worse than finding out you have the teleconferencing program on the day of the interview is having someone walk in during an interview. If there is any chance you will be interrupted, put a “do not disturb” sign on the door.

The format of virtual interviews generally is similar to traditional interviews. Most programs have eliminated the pre-interview dinner and other social gatherings. Interview days typically start with the program director offering an introduction to the program. Applicants then have individual interviews with faculty for the next several hours. Some programs also may include conferences or rounds on the interview day. The day usually concludes with a live or prerecorded facility tour.

Many programs send a single link to their interview. Applicants and faculty move into virtual breakout rooms as the day progresses. For example, one breakout room may be used for the program introduction, another for one interview, and a third for the morbidity and mortality conference. In this scenario, the program coordinator moves applicants between rooms.

In another scenario, the program may send multiple links to the applicant. One link may be sent for the conference, another for rounds, and another for each interview. This format requires additional planning. If an interview day is set up like this, make sure you have all the links required and that they match the itinerary.

Conclusion

Virtual interviews for surgical fellowship or residency programs can be a daunting process for both candidates and programs. Meticulous preparation including mock interviews, adequate technology, and a comfortable setting are key to achieving a satisfying interview experience.

References

1. Ellison EC, Spanknebel K, Stain SC, et al. Impact of the COVID-19 pandemic on surgical training and learner well-being: Report of a survey of general surgery and other surgical specialty educators. J Am Coll Surg. 2020;231(6):-613-626.
2. Tibayan FA. Commentary: Training in the time of coronavirus disease 2019 (COVID-19). J Thorac Cardiovasc Surg. 2021;161(1):185-186.
3. Sideris M, Hanrahan JG, Papalois V. COVID-19 and surgical education: Every cloud has a silver lining. Ann Med Surg (Lond). 2020;58(10):20-21.
4. Ungtrakul T, Lamlertthon W, Boonchoo B, Auewarakul C. Virtual multiple mini-interview during the COVID-19 pandemic. Med Educ. 2020;54(8):764-765.
5. Fried JG. Cost of Applying to Residency Questionnaire Report. Association of American Medical Colleges. May 2015. Available at: www.aamc.org/system/files/c/2/430902-costofapplyingtoresidency.pdf. Accessed February 5, 2021.
6. Kerfoot BP, Asher KP, McCullough DL. Financial and educational costs of the residency interview process for urology applicants. Urology. 2008;71(6):990-994.
7. Tseng J. How has COVID-19 affected the costs of the surgical fellowship interview process? J Surg Educ. 2020;77(5):999-1004.
8. Benson NM, Stickle TR, Raszka WV. Going “fourth” from medical school: Fourth-year medical students’ perspectives on the fourth year of medical school. Acad Med. 2015;90(10):1386-1393.
9. Association of American Medical Colleges. Virtual interviews: Applicant preparation guide. May 7, 2020. Available at: www.aamc.org/media/43051/download. Accessed October 28, 2020.
10. Seifi A, Mirahmadizadeh A, Eslami V. Perception of medical students and residents about virtual interviews for residency applications in the United States. PLoS One. 2020;15(8):e0238239.
11. Healy WL, Bedair H. Videoconference interviews for an adult reconstruction fellowship: Lessons learned. J Bone Joint Surg Am. 2017;99(21):e114.
12. Coleman JR, Abdelsattar JM, Glocker RJ, et al. COVID-19 pandemic and the lived experience of surgical residents, fellows, and early-career surgeons in the American College of Surgeons. J Am Coll Surg. 2021;232(2):135-137.
13. American College of Surgeons. Online guide to choosing a surgical residency. Available at: www.facs.org/Education/Resources/Medical-Students. Accessed January 19, 2021.