Residency, fellowship interviews transition from in-person to virtual
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As one of the many adaptations to the COVID-19 pandemic, residency and fellowship interviews will transition from in-person to virtual.
As a fellowship program interviewing in March 2020, our program learned many lessons about the virtual interview process. A successful virtual interview requires planning and practice. Programs need to select a workflow for the interview process. Will the faculty interview as a group or as individuals? Selection of the software platform, securing sufficient network bandwidth and ensuring candidates have seamless connectivity will require supportive information technologists.
Dissemination of information regarding each program is now more essential than ever. Candidates will not have the experience of visiting the city, meeting the office staff and faculty in a social setting, or even interacting with other interview candidates. To help bridge these gaps, creation of web portals, social media and messaging blasts will help candidates learn important details about the program.
Many of these efforts are positive strides that will ultimately enhance the interview process for years to come. However, the virtual interviews experience will be different for all involved. In this Healio Orthopedics Round Table, residency and fellowship program directors discuss strategies to help facilitate the transition from in-person to virtual interviews.
- Jonathan C. Levy, MD
Moderator
Roundtable Participants
-
Moderator
- Jonathan C. Levy, MD
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Fort Lauderdale, Florida
- William N. Levine, MD
- New York, New York
- Scott P. Steinmann, MD
- Chattanooga, Tennessee
- Jay D. Keener, MD
- St. Louis, Missouri
- Brian R. Wolf, MD, MS
- Iowa City, Iowa
Jonathan C. Levy, MD: How do you envision the interview format changing as programs convert to the virtual interview?
William N. Levine, MD: We do not plan on changing the format at all. We are patterning the virtual interview process identical to what we are doing for our residency program. We still plan on having a “social” the night before where our fellows will have an opportunity to interact with our fellows and the faculty in an informal, conversational way.
Scott P. Steinmann, MD: The transition from an in-person interview to the virtual interview will tend to limit the informal interaction that occurs during the interview day. Many programs have a dinner or lunch associated with the interview process and this informal activity allows the attendings and current fellows to interact with the applicants. This activity can be hard to create virtually. Many fellowship programs have instituted a coffee hour or happy hour that involves the current fellows or alumni meeting up virtually with applicants. Typically, the current attendings are not necessarily involved in this activity, which takes place weeks before the interview date. These informal virtual sessions can help increase interest in the fellowship.
The interview day itself has the ability to function efficiently since applicants do not need to walk between attendings offices but are placed into an interview queue. Eye contact and facial expressions will be different because most individuals do not tend to look directly at the small camera on the top of the laptop but stare at the person on the screen therefore changing the normal face-to-face interaction.
Jay D. Keener, MD: I agree with Scott’s sentiments. The format of the interviews will likely now incorporate more of a group rather than a one-on-one process. For example, two or three faculty interviewing the same candidate which will change the dynamics of the interview. We will record a video of our talk regarding the structure of the fellowship and living in St. Louis rather than a live presentation.
The inability to interact with the candidates during a social event will limit assessments to the CV and interview alone. I think this will place greater emphasis on the letters of recommendations and there will probably be more faculty discussions with the candidates’ home faculty. Some intangibles we seek with our fellows’ interactions with the candidates during the informal social gatherings will be lost.
Brian R. Wolf, MD, MS: The most glaring format change is the interview process is shorter due to the virtual process and the elimination of lunches, dinner and other informal parts of our usual “interview day.” Our usual full-day fellowship interview, as well as our day and a half residency interviews, are now condensed into 4 to 5 hours. Like Jay mentioned, we also have incorporated group interviews for our residency and assigned different topics of emphasis for each of the groups to cover.
Lastly, this year I think programs need to develop their own process of making sure interviewees get the information they want and need to know about the program, especially with the specialty fellowship interviews. This includes basic topics, such as salary and benefits, number of trainees, cost of living/ housing, etc. But it also involves specific items for fellowships that are program and specialty specific. For instance, with sports medicine fellowships, the applicants need to know specifics about team coverage responsibilities, hip or ankle exposure, rotation schedules and other details. Often much of this information was conveyed informally by question and answer over lunch or during a tour. Now, we have had to make sure these things are obvious from information on the website or through a live or recorded talk during the interview day.
Levy: What software interview platform fits your program best? Why?
Levine: We are using Thalamus because we contracted with them for our residency program in addition to six fellowship programs. Ease of coordination and positive feedback from many peers led us to go in this direction. We will carefully evaluate to determine if there is value added beyond simply using Zoom, which many programs are choosing to use.
Steinmann: We will be using Zoom, partially because most individuals are familiar with its interface and how to use it successfully. As a stand-alone online tool, Zoom is easy to navigate, but does not integrate with the programs’ own fellowship ranking process. There are other online entities that help you integrate the interview process into the selection process, such as Thalamus, but I have no experience with this.
Keener: We will use Zoom as well due to ease of use and familiarity.
Wolf: Our department is using Thalamus for both our residency interviews as well as our fellowship interviews. It has worked well for our residency interviews so far and has nice features. This includes scheduling, placing scores, having ready access to the application with a PDF embedded and single or group interview rooms, among other things. You can tell it was designed specifically for this type of application.
Levy: Transition to virtual interviews has helped many programs enhance their online presence. What has your program done to keep applicants informed about your program?
Levine: We have always had a robust website so that has not required any changes. We have created a short video including fellow alumni, current faculty and past faculty to highlight the fellowship in a more visceral fashion.
Steinmann: Keeping your fellowship website up to date is more important now, so applicants get a sense that this is accurate state-of-the-moment information. A great addition to your website are videos showcasing the fellowship with comments from the current fellows and the program director interspaced with video of the workspace environment, such as the operating room, clinic and anatomy or biomechanics lab. These videos should be no longer than 6 to 8 minutes, which most applicants will probably watch in its entirety. It is also helpful on the website to have a separate video showcasing the entire academic medical center complex and also a separate video showing what is great about the city or town where the fellowship is located.
Keener: I very much agree with Scott. Each fellowship will likely give more information on their website. In addition, increasing use of social media, such as Twitter and LinkedIn, will occur.
Wolf: For our residency we hosted three “Why Iowa” Zoom sessions to disseminate residency information. We also have focused on our website for both the residency and fellowships to make sure the information is accurate and updated. I agree with the others that other social media, such as Facebook, Twitter and others, are more important and we are trying to have a presence there as well.
Levy: Without a need to travel, the virtual interview format gives candidates the opportunity to apply to every program. Does this concern you? Do you feel there should be limits to the number of programs to which a candidate can apply?
Levine: I do not believe the virtual format has changed how many programs applicants will apply to, for fellowships anyway. Historically, the strongest applicants apply to what they perceive are the top-tier fellowships and the lower-tier applicants apply to most, if not all of the fellowships. I do not believe the pandemic will change this. There should not be limits to how many programs an applicant can apply. There is no reason to limit the number.
Steinmann: This could become an issue. Our residents are applying to a larger number of fellowship programs than in past years. The cost of travel, lodging and food is nonexistent, so we should expect an increase in the number of applications. Some applicants have also expressed that because it is a new process and not an in-person experience, programs may rely more on taking applicants from residency programs that they have done very well with previously.
It is an interesting question of whether there should be a limit of the number of programs to which a candidate can apply. Certainly, most of the fellowship programs will continue to interview about the same number of candidates that they have interviewed in past years. Even after the pandemic is over, we should not expect the interview process to return to how it was in 2019. Many programs will continue to use a virtual interview or a hybrid type of process. In the highly competitive subspecialties, limiting the number of programs to apply to could become an issue whereas some subspecialties that are not as competitive would not be affected by this process.
Keener: In my opinion, this is not that much of an issue. We review applications and selectively invite candidates based on merit just as before. I think a greater percentage of candidates will accept the interview given the lack of need for travel.
Wolf: This is an important issue and it will be interesting to see how it plays out. I don’t think anyone knows if it will cause problems or not, but there is legitimate concern. In years past, applicants had to decide between programs when accepting interviews due to time and travel considerations. They could not be in two places at once. If an applicant declined an interview, then many programs would subsequently offer an interview to the next candidate on their list. In this interview cycle, applicants possibly could do two interviews in 1 day. And there is concern that the “top” candidates will be offered and take more interviews because they did not have to make “cuts” due to travel and cost. So, there is concern there could be a maldistribution of interviews toward the applicants who look the best on paper.
I will put on my AAOS Fellowship Committee Chair hat now to finish my answer. There is consistent information that applicants do not need to interview with more than 10 to 12 programs. An applicant that does 10 to 12 interviews has an extremely high likelihood of matching. We have tried hard in the past, and even more so last year, to educate fellowship applicants about this and to encourage some restraint on how many interviews they accept. There have been proposals in the past about limiting applications, but this is a difficult issue to regulate.
To be fair, this is a two-sided coin with issues related to fellowship programs as well. For years, we have had programs interview “too many” applicants, such as 40-plus applicants for one position. This has consistently prompted complaints from applicants in post-match surveys. When programs interview this many applicants, it also likely prompts applicants to apply and interview with more places. So, it turns into a vicious cycle.
There have been discussions on mechanisms to limit how many applicants a program could interview, but no solutions have been obvious. It is imperative that programs also show restraint in how many applicants they interview. Our committee has generally recommended no more than 16 to 20 applicants interviewed per position offered. We have also had special webinars to educate programs on this topic this year. It is also imperative this year that residency and fellowship programs be realistic on the applicants they are interviewing. If you are at a program that generally does not get the top tier applicant, then your program should be interviewing candidates consistent with your historical match results.
Levy: Programs have all agreed not to have communication with candidates after the interview. However, with the sense of insecurity that comes from a new interview format, do you see “illegal” communication becoming an issue?
Levine: I certainly hope not. There is no difference during the pandemic compared to other years. No communication means no communication. If a program doesn’t abide by this policy, I do not believe a pandemic is going to change that behavior. The American Shoulder and Elbow Surgeons has worked diligently during the past decade or more beginning with Ken Yamaguchi, MD, MBA, who fought feverishly to eliminate all communication, and we should continue this tradition. It is in our applicant’s best interest to not communicate, unduly pressure or in any way compromise the integrity of the match which we have worked so hard to perfect over the past decade plus. We owe it to each other to maintain the professionalism, collegiality and integrity of the process so I hope everyone agrees with and abides by this policy.
Steinmann: Yes, it is an important part of the code of conduct that candidates do not communicate with the fellowship program other than for sundry informational items from the program coordinator. Also, attendings at a candidate’s residency program should not contact attendings at the fellowship program after the interview. Also, visits from residents in an across-town program, even though local, should not occur.
Keener: Adhering to the “spirit” of the match and the established rules is important. We are relying on the honor system here. I fear there may be some informal visits to programs that may occur. Breaches of the rules should be dealt with seriously.
Wolf: This is a crucial topic and question. I sincerely hope that there is no “illegal communication.” We rely on our fellowship specialty societies to monitor this, and many of the specialty societies have penalties in place for programs that do not comply with the rules about communication. All fellowship specialty societies have agreed on the code of conduct for fellowship interviews.
As Scott noted, there is to be no communication between programs and applicants after the interview. Any communication about where an applicant is on the rank list is strictly forbidden at any time. This includes communication between the faculty at the applicant’s program and the faculty at the fellowship program. Rampant communication is what destroyed the fellowship match in the past. I remember those days because it was a broken process when I was applying to fellowships. There were “exploding offers” and rampant phone calls about rank lists. It was terrible for applicants and programs. So, I implore everyone to please play by the rules.
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