Residency Match: Concerns emerge about distribution of interview slots

Time and cost. Those are the typical barriers associated with the residency interview process. Fourth-year medical students simply can’t afford or can’t spare days away from school to go on dozens of interviews.

In this year’s residency-selection process, interviews have gone virtual, largely eliminating these barriers. As a result, concern has surfaced that the applicants perceived to be in the top tier will accept a higher percentage of interview invitations, which may limit opportunities for others. While data has yet to come out on potential interview inflation, the Association of American Medical Colleges (AAMC) addressed the realities on the ground in a recent letter to academic faculty.

“We are seeing students in the highest tier receiving a larger number of interviews per person than in past years, leaving other students—including those in the middle of the class—with fewer interviews than we would anticipate based on their qualifications,” says the letter, written by Alison Whelan, MD, the AAMC’s chief medical education officer.

Find out more about how medical students can manage the stress of virtual interviews.

Interviews may be harder to come by this year, according to Eric Strand, MD, professor of obstetrics and gynecology and the ob-gyn residency program director at Washington University in St. Louis (Wash U.).

“There’s a lot of fear among students worried about their opportunities,” Dr. Strand said.

Anecdotally, Dr. Strand has heard from faculty at other institutions that they have seen qualified students getting fewer interview slots. Because of that, the AAMC letter made a request of students: Consider releasing interview slots if you are holding more than needed.

That highly unusual request comes during a residency selection cycle that has been surrounded by uncertainty amid a once-in-a-lifetime pandemic that has upended American life and medicine.

“We have been aggressive in counselling our students that you don’t want to hoard interviews because of the negative impact that it could have on your colleagues,” Dr. Strand said.

The request does put students in the strange position of having to objectively evaluate their candidacy in a process during which little can be taken for granted.

“This year, of all years, it’s really hard to tell students to limit their opportunities—the impact for a student of not matching is tremendous,” Dr. Strand said. “Given all the uncertainty this year, with a pandemic, no away-rotations, all interviews being done virtually, it’s really hard to command a student to limit their interviews. They are the ones that have the most at risk.

“We can show them the data that says that if you are a top-tier student with all these [interview] offers, the likelihood of not matching is exceedingly low. But they are also coming at it from a perspective of, ‘If I don’t match, that’s a problem for my career.’ I can understand their desire to be overly cautious.”

Learn with the AMA how residency programs will view applications in 2021.

The same students going on more interviews could mean programs will have a harder time filling all their residency slots. In response to that possibility, the AAMC has advised residency programs to conduct more interviews.

At Wash U., the ob-gyn program increased interviews by about 8%. That was in part due to concerns of application inflation and in part related to the ability to accommodate more applicants in a virtual setting. Of accepted interview invitations, there have been fewer cancellations than in years past, Dr. Strand said.

Find out which factors applicants weigh most when picking residency programs.

Some students may get fewer interview invitations than expected. In those instances, it’s a good idea to meet with an adviser to discuss your Match possibilities. With interviews wrapping up at most schools by the end of January, the focus should be on the opportunities that do remain.

“Try to make the very best out of a stressful situation,” Dr. Strand said. “Prepare for the interviews you do have, so that you can make a favorable impression. It only takes one program to be impressed to gain a Match.”

In the end, even if students have fewer interviews than expected, the math is on their side. Graduates of U.S. MD-granting and DO-granting medical schools matched at a clip higher than 90%.

“Match statistics are still incredibly encouraging,” Dr. Strand said. For matched applicants, more than 80% will match at one of their top four choices. So, there’s not only an excellent chance that most applicants will match, but also match into one of their most preferred programs.”

During Match Week, unmatched applicants and unfilled programs will work to match with one another through the National Resident Matching Program’s existing Supplemental Offer and Acceptance Program (SOAP). Four rounds of SOAP have been planned for 2021—that number is traditionally three. Given the uncertainties surrounding the Match this year, it remains to be seen how busy SOAP will be in 2021.

The AMA has curated a selection of resources to assist residents, medical students and faculty during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events at this time.