Date: July 15, 2019
As the number of applications reviewed by residency and fellowship programs continues to increase year over year, GME programs are fraught with increasingly difficult decisions in planning their interview seasons. Much of this burden falls onto the program coordinator and other program administrators, with input from the program director.
While intuition and prior experience are certainly key, the equation for success is rapidly changing with the rise of new technologies.
Online interview scheduling software solutions such as Thalamus are now widely used. These are slowly replacing emails and phone calls, meaning that new strategies must be employed to optimize the interview season. Long gone are the days of racing to invite your most preferred applicants immediately upon the Electronic Residency Application Service (ERAS) season opening.
Here is our list of questions you should be asking yourselves prior to your interview season. The answers will ensure you optimize your recruitment process and match the best possible residency and fellowship candidates!
In the days of scheduling interviews via email and phone calls,
candidates were met with the uncomfortable task of having to contact a program directly in order to cancel or withdraw, or they could no show. Interview scheduling software allows candidates to cancel/withdraw immediately and seamlessly, thereby providing programs with higher turnover in general.
“But we don’t want high turnover!!!!” And no program does. However, turnover isn’t a negative. It means that you aren’t interviewing someone who has no desire to come to your program.
This brings up a very important point:
Your interview season is meant to ensure you match the best candidates. The goal of your interview season is not to interview the most candidates or to ensure that no-one cancels/all of your dates are full.
The reason for this is that while candidates apply to more and more programs, the number of candidates applying has remained generally fixed. As a candidate may only attend one residency program, this means that any candidate you interview is less likely than ever to attend your program.
And while inviting MORE candidates may seem like the ideal solution, it is not. As more and more programs invite more candidates, all that increases is cost.
The key is to invite candidates that have a higher percentage likelihood of matching at your program. This means, don’t overreach for candidates you are unlikely to recruit or from a non-representative geographic area with no ties to your program.
“But our program is the best in the country. Everyone wants to come here.”
While this may indeed be true, there are many “best” programs in the country. And what is best for one candidate may not be what your program offers. For instance, if a candidate from the west coast decides not to interview at your east coast program (or vice versa), it may mean nothing more than the candidate doesn’t want to live on the opposite coast. Your program didn’t “lose” the opportunity to recruit this candidate. Rather, your pre-season probability of recruiting them to begin with was already low before a single interview invite was sent out.
The match season is like the NFL/NBA/NHL/MLB draft. There are only so many teams and so many players. Maximize everything you can do to get the best team of residents and recognize that in doing so you are competing against every other program’s team in the country. You aren’t recruiting in a silo, but rather a dynamic system that includes a known domino effect, with an optimization strategy similar to the Moneyball thesis:
“The Moneyball thesis is simple: Using statistical analysis, small-market teams can compete by buying assets that are undervalued by other teams and selling ones that are overvalued by other teams.”
This means your best bet may be to recruit candidates who will succeed at your program, that other programs may or may not recognize, similar to a baseball player who always hustles, but doesn’t hit a large number of home runs.
Again, interview-scheduling software has changed the calculus here. Our top tip:
Do not invite more candidates that you have interview positions.
Again, Do not invite more candidates that you have interview positions!
Software allows interview seasons to fill quickly, usually in two to twenty-four hours depending on the number of candidates interviewed. If you invite 100 candidates more than you have interview positions, there are 100 candidates who are going to be both frustrated and confused by your program. Several specialty organizations including the Alliance for Academic Internal Medicine (AAIM) have even created official policies and guidelines to handle such matters
Obviously, your program may need to eventually invite more applicants than interview spots as cancellations increase over the interview season continues. However, this is very different than over-inviting candidates on day one.
Inviting fewer candidates initially gives your top candidates more choices of interview sessions, which means greater flexibility, greater ease of rescheduling, and applicants who will more strongly favor your program (candidates landing on a full calendar will instantaneously recognize that they are not your program’s top choice). Further, inviting fewer candidates will decrease the anxiety of a “first-come, first-served” rush.
In a similar light, programs that invite candidates in “waves” or “batches” tend to have lower cancellation and rescheduling rates, because applicants have more flexibility given less of a frantic rush to sign up for a date before everything fills. This also helps combat issues with “first-come, first-served” complications and provides candidates lengthened opportunities to schedule if they are away from their devices or involved in patient care when receiving their initial interview invitation.
The number of candidates you invite will ultimately determine a key metric for success in your interview season. Ensure you have a strategy set up prior to inviting your first candidate.
Ideal interview days are both program- and geography-specific. And again, it not only depends on what days your program interviews, but also how many competing programs within your specialty (or even outside your specialty) and your geographic area are interviewing on the same day.
Candidates love traveling to warm climates in the winter. Many will likely want to travel to programs with more severe winter weather earlier in the fall to avoid the cold and snow and also the accompanying travel delays and cancellations.
Some programs to help streamline the process for their candidates share their dates with other programs in the area. This allows candidates who have been invited to multiple programs in a region to make one trip to that region which saves both time and money. Your candidates might even thank you for it!
“But we never fill our January interviews!”
The reassuring news here is that very few programs do. Candidates are now applying to ~60 programs for US graduates and ~150 programs for IMGs. They tend to over-interview and burn out as January and February approach. The result is that very few programs fill their January interview dates (note: Fellowship programs usually do not have this problem given smaller interview cohorts and less available dates).
However, consider that candidates who do show up to interview in late January/early February are certainly still strongly considering your program (or they would not pay to travel to your program that late into the season). Indeed, we’ve heard many stories from our program users that some of their best residents interviewed on the last day of the season!
In the past, “getting to” an applicant first meant they were definitely likely to interview with your program. Today, applicants are applying to more programs than ever, and interviewing is becoming more and more expensive (as candidates may take up to $25K in additional loans on top of their medical school debt to pay for the interview process).
Over-application means that many candidates are invited to more interviews than they plan on attending (sometimes by a large margin). As such, candidates are changing and rearranging their schedules more frequently, often replacing programs they are less strongly considering with their top choices as more programs send out their interview invitations with the progressing season.
Thus, when your program sends out interviews will ultimately determine how many candidates you interview, as well as the number of cancellations, rescheduling, and withdrawals. As no program is equal, this too is quite program-specific. However, there is very little benefit to rushing to invite candidates, especially prior to Medical Student Performance Evaluation (MSPE) Letters. “Dean’s Letters” are released on October 1st. This holds true for fellowship programs as well—don’t rush, candidates will schedule and fill your interview season quickly regardless.
Therefore, programs should strongly consider inviting candidates when ready, without rushing, and certainly after October 1st. Inviting early leads to more turnover, while waiting a few weeks for more programs to invite will ensure candidates that accept your invitation actually do want to come to your program. This is another benefit of inviting candidates in waves as well (more choice and less rush mean happier candidates more determined to interview at your program).
The one caveat is… don’t send out your invites too late either. While this may allow you to only interview candidates who are more strongly considering your program, inviting too late may limit this pool even further, as candidates start to sacrifice attending additional interviews as they burn through funds. Or alternatively, they may feel like they have already secured enough interviews to secure a match at a program they would be happy attending.
Residency and fellowship interview scheduling is kind of what we do…
Team Thalamus is composed of prior/current applicants, program coordinators, program directors, and GME leadership. We are also a team of academics and data scientists who love to nerd out about the application, interview, and match process. Indeed, we’ve been collecting and studying the data now for over half a decade. We love doing it so much we’ve committed ourselves to analytics initiatives and submitted manuscripts to academic journals (as well as written blog posts) about it.
Further, we’re in the process of building products where both programs and candidates can leverage our solutions to help make data-driven decisions about their recruitment seasons. We believe the lessons learned will streamline and optimize the process, while lowering costs for all.
Should you want to learn more, please contact us anytime at firstname.lastname@example.org.
Want to have the best interview season yet? We’d love to work with your program and use our data-driven solutions to maximize your program’s recruitment this interview season! We invite you to request a demo to get started.
Team Thalamus is a grassroots collaboration of applicants (past and present), program directors, program coordinators and other GME leadership who wish to share our collective journeys through managing and participating in years of residency application cycles. While we offer a byline to all of our contributors, many wish to write under a pen name, which we have collectively defined as Team Thalamus. Becoming a physician is a long and winding road, filled with sacrifice, dedication, complexity and uncertainty and our team is her to help!
Thalamus is the premier cloud-based interview management platform designed specifically for application to Graduate Medical Education training programs. We are the experts in the residency and fellowship application processes. Learn more about Thalamus.
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