Community Findings on How the GME Community Can Optimize Structuring Interview Scheduling

Based on Virtual Forum, Hosted by Thalamus

The residency recruitment process has shifted to the virtual world as a result of COVID-19. While there have been some marked improvements, this novel environment has exacerbated several pre-existing challenges. At the forefront: the stress and anxiety related to interview scheduling and the resulting effects of the 24/7 nature of the internet, which is further challenged by the demanding schedules for applicants and programs throughout US and global time zones.

In the midst of interview scheduling, challenges can arise for both applicants and programs.
Applicants often feel frustrated that their scheduling periods are brief, unpredictable and inconveniently timed, even as some specialties transition to common interview releases.
Programs are working to schedule hundreds of interviews for applicants from all over the US (and across the world), in many different time zones, within a constrained time period while working to maintain equity.

Below is an overview of insights gathered during Thalamus’ recent Community Forum on, How the GME Community Can Optimize Structuring Interview Scheduling, which was attended by GME stakeholders including program directors, coordinators, current residents, applicants, and others.

GME Interview Scheduling & the Current Status Quo

Historically, even prior to interview scheduling software, applicants would have to wait by their phones and computers to respond to interview invitations. A decade ago this was predominantly done by email or phone call, and required applicants to list preferences of interview dates and then wait for a response to confirm such dates (which would come up to several weeks later).

Today, the process is similar, except that there is greater transparency in the “race” for interview positions. Rather than not knowing the position of their email response relative to other applicants in a program administrator’s inbox, interview scheduling software allows applicants to view how many positions remain.

As programs reach out across time zones, oftentimes globally, invitations arrive in applicant inboxes at all hours of the day (though typically within standard business hours or at least waking hours as shown in the graph below).

% of Thalamus interview invitations sent by hour of day (EST)

Today, applications are increasing, but match rates are staying the same.

Year-over-year, more applicants are applying to more programs, with the average in the mid 70s according to 2022 AAMC/ERAS data. But the good news is that match rates haven’t changed much; they’re around 95% for MDs and in the low 90s/high 80s for DOs and down to about 50% – 60% for IMGs.

What has changed with virtual interviews?

Virtual interviewing appears a win-win for everyone involved.
Applicants save thousands of dollars in travel expenses.
Programs don’t have to allocate financial or human resources to fulfill their interviewing responsibilities.
Data shows that match rates haven’t notably changed with the transition to virtual interviews.
The most noticeable challenge of virtual interviewing is that applicants are unable to get the “look and feel” of the program and surrounding geographic area in person. Some programs have tried to mitigate this through virtual tours, “day in the life” videos and other marketing efforts.

How Are Programs Attracting Applicants?

Connect with applicants at national conferences and networking meetings, and hold on sending out invites until you’ve met with applicants at these events.
Start with applicants in your region, and offer practice interviews.
Overall, it’s really important to provide applicants with a positive, healthy and transparent experience.
For applicants traveling for in-person interviews, provide a “road trip” itinerary with current residents’ favorite hot-spots.

Strategies to Innovate Interview Scheduling

Common Interview Release Days

Used by several specialties currently including OB-GYN, Orthopaedic Surgery, Urology and Dermatology.
These come in different “flavors” but either result in programs committing to send out interviews on a particular day and/or particular time, and may or may not include a 24-48 hour moratorium between when interview invites are sent and when scheduling is allowed to occur.
Specialties that coordinate a particular time for scheduling result in the fastest filling of interview positions.

Intentionally Deconflicting

Though it’s not always possible, intentional coordination amongst programs within a specialty (or region or other competitive metric) to avoid offering conflicting interview dates can be extremely beneficial to applicants, and presents your program in a very positive light.
Doing this regionally often makes the most sense, and some programs are creating a centralized calendar in the spirit of transparency, with the best interests of applicants in mind. This benefits the market, prevents misinformation, and builds good will.

Intentionally Conflicting

Alternatively programs within a specialty may only offer interview dates that deliberately conflict with a competing program, in an effort to eliminate them as an option for highly competitive applicants.
This practice actually does a disservice to both programs. By forcing applicants to make a choice on where to interview, this potentially eliminates desirable applicants matching at a program where they forgo an interview for this reason.

Limiting Available Days

To ensure filling of interview positions, some programs choose to offer a select handful of dates to various groups of applicants.
This tends to be a strategy that was employed prior to interview scheduling software. Instead of limiting dates for applicants, programs that provide more flexibility and availability of dates to applicants tend to have higher interview completion rates and less cancellations (because applicants can pick dates that work best for them and therefore decrease the need to cancel/reschedule.
Positive reasons for limiting available interview days are it can provide more time to review applications and promote more thorough holistic review.

Thalamus’ Preferred Method to Optimize Interview Scheduling:

Invitation Waves

Sending invitations in waves has multiple benefits including:
- Optimal filling of interview dates
- Decreased cancellations
- Signaling interest to applicants invited in earlier waves, a passive form of preference signaling from program to applicant.
- Improved applicant satisfaction

Note: Several forum attendees mentioned experiencing fewer cancellations when using this approach.

When should programs send interview invitations?

“Goldilocks” strategy appears optimal (not too early, not too late, but “just right.”)
- Inviting applicants too early can result in increased rescheduling amongst applicants after they are invited to other programs. Inviting early was a strategy more frequently employed prior to interview scheduling software, where the cost of switching interview dates was higher (by email or phone call). The advantages of inviting quickly have diminished with interview scheduling software. Similarly, programs that invite applicants to interview on the first day of the interview season are signaling to applicants that they may have not fully read their entire application. Alternatively, some programs will invite applicants known to them (e.g. internal applicants) or very desirable applicants early.
- Inviting applicants too late can result in decreased scheduling as some applicants may have already hit their quota for the number of interviews they will complete.
- Determining “just right” for a program is based on several factors including program geography, specialty, desirability, prestige, available interview dates, other programs interviewing on similar days and more. Program leadership should collaborate both within their program and within their specialty where appropriate to determine these factors.

A Note on Second Looks

Some applicants are requesting and some programs are offering ‘second-looks.’
With two years of virtual interviews for GME, issues regarding equity are the largest challenges currently with second looks.
- Not all applicants have the financial resources to afford second looks.
- Second looks prior to submission of match lists present potential unfair advantages in applicants who want to signal greater interest in a program and could potentially influence placement on rank list.
- Novel ideas such as split rank list submission have been proposed (i.e. programs submit rank lists x number of weeks prior to applicants. Once program match lists are submitted, applicants can then complete a second look without fear of the visit affecting rank list placement.
A lack of interest in a second look with a program may not correlate with an applicant’s interest in a program (e.g. some applicants can identify a top choice program after a single interview day).

Additional Recommendations

Over-communicate in the scheduling process with applicants as well as faculty. Make sure all participants are aware of all the details of the interview, including scheduling practices and procedures.
Applicants and programs should recognize that there are people on both sides of this process. Kindness, empathy and understanding can help improve the process for all.

Conclusion:

There are several factors relating to GME interview invitations and scheduling behaviors that affect both applicants and programs. Optimal strategies are based on both program and applicant preferences and characteristics, and have evolved over time with the advent of interview scheduling software. Inviting in waves benefits all GME stakeholders. Deliberate strategies and practices can be used to optimize outcomes.

Many thanks to our forum attendees, as well as Jason Reminick, CEO & Co-founder of Thalamus, Suzanne Karan, MD, FASA, Co-founder of Thalamus, and Ephy Love, PhD, Head of Data Science at Thalamus, who all provided additional context and data-driven recommendations on how the GME community can optimize structuring interview scheduling. We appreciated the enthusiasm and active participation of our attendees. The discussion generated some great insights into how different programs across the country handle this challenging process. We hope that these engaging conversations will continue to provide clarity and enable open dialogues for stakeholders across all of GME.