With the ERAS 2021-2022 Application Season and Match 2022 underway, applicants have already begun receiving invitations to interview for residency. At Thalamus, we are entering our 8th match season, making us the “youngest old folks” in the room. Consequently, we have come to appreciate the growing role of social media in medical education, specifically the flourishing, #MedTwitter, #MedStudentTwitter, #ERAS2022 and #Match2022 communities/hashtags. In parallel, there are truly heroic efforts already underway, by applicants, to build Google Sheets and Reddit communities to track interview offers with masterful ingenuity. Within these communities, we’ve noticed 3 predominant themes:
- Applicants celebrating an interview offer during the first week of ERAS.
- Applicants questioning why they (or anyone) would get an interview offer during the first week of ERAS.
- Program and GME leadership wondering how some programs can send interview offers in the first few days, when another program takes weeks to send out invitations.
In the impending era of USMLE Step 1 going pass/fail in favor of a broader holistic review to promote diversity, equity, and inclusivity in recruitment, how are any of these possible?
On Twitter, the predominant answer seems to be that early invitations are sent to internal applicants or filtered applicants with high boards scores. This is certainly partially correct, in that there are programs who invite internal applicants or use simple filters to narrow down their applicant pool. However, there is much more to unpack here.
Thalamus works with approximately 3,000 residency and fellowship programs, across 100+ specialties at 200+ institutions. We’ve been observing and participating in this process for nearly a decade. And we’ve often had this question ourselves. So, we took advantage of our research team and analytics database to take a deeper dive into what getting a residency interview invitation during the first week of ERAS really means.
Important Background: The National Resident Matching Program (NRMP) is a two-sided marketplace that matches applicants to programs. There are approximately 50,000 applicants per year, vying for approximately 35,000 residency positions at thousands of programs throughout the country. In the scale and randomness of it all, it does feel as though applicants could end up at any of the residency programs within a specialty (or group of specialties if applying to multiple). However, the fact is that both programs and applicants have choices and priorities. In short, beyond applicant characteristics there is significant variation of preferences by geographies, specialties, practice environments, program/institutional missions, personal preferences and many more, all of which contribute to match outcomes. So, let’s start on the premise that no two applicants and no two programs are completely identical in their preferences.
Point #1: I got an interview the first day ERAS opened. Surely, the program just applied filters and invited everyone meeting a certain threshold. Or perhaps it was just my home program that invited me? Or a program I rotated at?
Again, this does happen. For the home programs/rotated programs, it is most easily understandable. Most programs will invite their internal applicants anyway, assuming no red flags in an application or other conflicts of interests. In part, this is a courtesy to allow for practice for other interviews and in part because they are very familiar with the applicants already. The same can be extended to rotating students.
But what about programs that just filter on easily quantified metrics such as board scores? This is where the conversation gets more nuanced.
What about if a program is inviting the majority of their applicants on the first day; how could they possibly review all applications in their entirety? The short answer is they likely cannot, assuming their faculty did not read more expediently than other programs’ faculty or said filters have been applied.
Overall, we believe that this practice of inviting early is mostly a relic from the days prior to interview scheduling and virtual interview software, where emails/phone calls were the primary medium of communication between programs and applicants. Due to the inherent technological limitations, there was a common belief among programs that if an applicant scheduled with the program early, there was a higher likelihood of the interview being completed. Over recent years, with interview scheduling being streamlined by software (even prior to COVID-19/virtual interviews), we have actually seen higher cancellations and decreased completed interviews amongst applicants at these programs that are inviting early, en masse. (For a deep dive on this subject check out our Residency Program Interview Process Best Practices Guide.
But there are other possibilities than filtering and fervent attention from faculty:
- The program is constrained in their realistic applicant pool by the program’s location and believes getting their invites out first provides them an advantage in enticing applicants to interview at their program, despite geographic challenges.
- The program is in a specialty where many applicants are needed to be interviewed per matched position to fill their available positions. Family medicine is one of these specialties, for which we have measured the highest applicants interviewed per matched spot of any specialty, at a ratio of ~30-40:1 on average.
And perhaps most important:
- The program is inviting a small subset of applicants during the first week out of preference or convenience: Those applicants that the program director immediately feels best match the specific recruitment criteria for their program and are thus likely to match. Remember, programs rarely send out all invitations at once, and all have different strategies for how to tackle their applications.
Point #2: So if I get an invite during the first week, does that mean I’m a strong applicant? Or conversely, if I don’t get an invite the first week, does that mean I’m not a strong applicant?
Applicants should be proud of the interviews they receive during the interview season. It is a marker of achievement in medical training and life goals and is undeniably a step closer to matching.
However, if you are watching social media, thinking, “Holy cow, all these people are getting interview invitations, where is mine?!?!?”, please do your best not to worry (…I know, easier said than done).
Depending on the institution and the specialty, some programs historically send out invitations the first week, and others simply do not. It may just be the programs you sent application to do not even begin to review applications in these first few days.
Additionally, several specialties participate in common release interview days, such as OB-GYN (10/19/21) and Orthopaedic Surgery (11/15/21). If you’re applying in these specialties, it is possible to get an interview invite sooner, but the very large majority of invites will be sent out on the predetermined dates. Historically, Dermatology is one of several specialties that interview later in the season(December/January). As such, a Dermatology invite in the first week is rather uncommon.
An invitation in the first week really tells you only one thing: you got an invitation. And that is a wonderful thing. If you get an invite during this time, congratulations! If you do not, try to avoid getting too in your head. It is likely irrelevant to your career as a physician and is only a marker of the above factors, all of which are likely out of your control.
Point #3: What does the actual, temporal distribution of interview invitations look like in GME:
A lot like this.
This graph represents hundreds of thousands of interviews, across all major residency specialties. Thalamus’ data accounts for 25-60% of interviews for each specialty (i.e., this is a large sample).
This is the approximate graph we’ve seen in some form over the last 8 years, with the following caveats:
- Due to COVID, the ERAS 2021/Match 2021 started on October 21st (3 weeks later than the 2022 season, and greater than 5 weeks form the usual September 15th start date) with a regularly scheduled Match Day on the 3rd Friday of March. This meant more programs than usual had to invite earlier, to start interviewing soon after that given a shortened overall interview season last year
- Week 2 and Week 3 historically have the highest density of interview invitations.
- Specialties that invited on a common interview release day would represent a single large spike over one day on this graph.
- Some, but only a small percentage of invitations were released on weekends.
- Some, but only a small pertentage of invitations were released in the evening or overnight.
- Invites continued late into February/early March for some programs/specialties (due to wait list movement, cancellations, etc.).
So, what does this mean for #ERAS2022/#MATCH2022?
Well, we expect the same distribution as above, but a little less tall and a little wider (given the 3-week earlier start), meaning more invitations outside of the first week.
For a variety of reasons, invitations do go out the first week of ERAS opening. If you receive one (or more), that’s awesome! If you don’t, no worries! Interview season is a marathon, not a sprint. Your invitation timing cannot define you as an applicant. Some programs, after having read your applications, do rush to send out invites during this time for the right reasons, some do it for less optimal reasons, and some do not rush at all. An early invite is simply of no greater value than a later invite and a first week invite, is in no way correlated to the number of invites you will receive overall throughout the interview season. Applicants and programs each have their own strategies, and we hope this data has been helpful in providing guidance after this first week.
And in case you were wondering, we are already seeing the expected trends for #ERAS2022/#MATCH2022.
We hope everyone has a great interview season. Remember, the objective is matching, not maximizing the number of interviews you receive. While more interviews naturally increases your chances of matching (up to a threshold), every year there are applicants with only one interview who match. Somewhere between nothing and very little is determined by the first week of match season. We are here to support you as always. Please feel free to interact with us on twitter @thalamusgme! We read all your messages and we love answering questions. Happy Interviewing!