ABSTRACT

Background

Travel costs and application fees make in-person residency interviews expensive, compounding existing financial burdens on medical students. We hypothesized virtual interviews (VI) would be associated with decreased costs for applicants compared to in-person interviews (IPI) but at the expense of gathering information with which to assess the program.

Objective

To survey senior medical students and postgraduate year (PGY)-1 residents regarding their financial burden and program perception during virtual versus in-person interviews.

Methods

The authors conducted a single center, multispecialty study comparing costs of IPI vs VI from 2020-2021. Fourth-year medical students and PGY-1 residents completed one-time surveys regarding interview costs and program perception. The authors compared responses between IPI and VI groups. Potential debt accrual was calculated for 3- and 7-year residencies.

Results

Two hundred fifty-two (of 884, 29%) surveys were completed comprising 75 of 169 (44%) IPI and 177 of 715 (25%) VI respondents. The VI group had significantly lower interview costs compared to the IPI group (median $1,000 [$469-$2,050 IQR] $784-$1,216 99% CI vs $3,200 [$1,700-$5,500 IQR] $2,404-$3,996 99% CI, P<.001). The VI group scored lower for feeling the interview process was an accurate representation of the residency program (3.3 [0.5] vs 4.1 [0.7], P<.001). Assuming interview costs were completely loan-funded, the IPI group will have accumulated potential total loan amounts $2,334 higher than the VI group at 2% interest and $2,620 at 6% interest. These differences were magnified for a 7-year residency.

Conclusions

Virtual interviews save applicants thousands of dollars at the expense of their perception of the residency program.

ABSTRACT

Background

The effect of virtual interviews on residency match outcomes during the COVID-19 pandemic is unknown. Examining the ophthalmology match may help inform all specialties undergoing virtual interviews.

Objective

To determine the impact of allopathic applicant match characteristics in the first year of the virtual residency Match process.

Methods

Using the Association of University Professors of Ophthalmology match database, a retrospective review was conducted of all allopathic applicants to ophthalmology residency programs in the United States from the 2016 through the 2021 match cycles. Demographic information, interview numbers, and match outcomes were compared between the 2016-2020 (in-person) and 2021 (virtual) cycles.

Results

A total of 3343 allopathic applicants were analyzed. Applicants in the 2021 Match applied to significantly more programs than 2016-2020 applicants did (78.7±23.6 vs 73.1±22.7, P<.001). Among matched and unmatched applicants, there was no significant difference in the number of interviews granted or completed. There was a significant reduction in the match rate between the 2016-2020 and 2021 Match cycles (81.3% vs 76.6%, P=.0009). A subanalysis of applicants who went to medical schools with ophthalmology residency programs (N=2308) found that the home institution match rate was significantly higher for the 2021 Match compared to the aggregate 2016-2020 Matches (26.1% vs 20.6%, respectively, P=.015).

Conclusions

Significantly more applicants to ophthalmology residency programs matched at their home institutions in the 2021 virtual match cycle compared to the previous 5 years without influencing the interview numbers granted and attended.

ABSTRACT

Background

Non-US citizen international medical graduates (IMGs) make up a significant proportion of the physician workforce, especially in physician shortage areas and specialties. IMGs face barriers matriculating in US residency programs. Whether a program reports accepting J-1 visas and sponsoring H-1B visas influences their decision to apply, it remains unclear which institutional factors shape programs' likelihood to consider visa-seeking applicants.

Objective

We investigated factors associated with programs reporting accepting J-1 visas or sponsoring H-1B visas for non-citizen applicants in internal medicine, the specialty most sought after by IMGs.

Methods

We performed multivariable regression analyses using publicly available data to identify characteristics associated with reported visa acceptance (J-1 and or H-1B). Covariates included university affiliation, program size, program type (academic, university-affiliated community, or community), and Doximity reputation ranking.

Results

We identified 419 programs: 267 (63.7%) reported accepting J-1 visas. Among programs that accepted J-1 visas, 65.6% (n=175) accepted only J-1 visas while 34.5% (n=92) sponsored H-1B and accepted J-1 visas. Ranking in the third quartile (vs first quartile) was associated with lower odds of accepting J-1 (aOR 0.12; 95% CI 0.02-0.87; P=.04) and sponsoring H-1B visas (aOR 0.19; 95% CI 0.05-0.76; P=.02). Community status (vs academic) was associated with lower odds of accepting J-1 visas (aOR 0.2; 95% CI 0.06-0.64; P=.007), as was county hospital affiliation vs non-county hospitals (aOR 0.22; 95% CI 0.11-0.42; P<.001).

Conclusions

While prior evidence shows that most internal medicine programs that substantially enroll IMGs are low ranking, high-ranking internal medicine programs are paradoxically more likely to report that they consider and sponsor visa-seeking applicants.

The Challenge

“OMG I've just completed residency and now I'm a clinical teacher.”

“I think I want to become a clinician educator but I'm not sure how.”

“I don't understand my role or how I will know that I am successful as a clinician educator.”

Physicians arrive at their jobs through a clearly delineated pathway that extends from medical school through specialty certification and employment. In contrast, clinician educators (CEs) must discover and then navigate an array of potential pathways that are dynamic, evolving, and individualized. CEs may complete graduate degrees, medical education fellowships, or faculty development programs. They may

Editor's Note: The following are the Top Research in Residency Education abstracts selected by the Journal of Graduate Medical Education and the Royal College of Physicians and Surgeons of Canada for the 2022 International Conference on Residency Education (ICRE).

Top Research in Residency Education

Differential Attainment at the Intercollegiate Membership of the Royal College of Surgeons Examination: A High-Stakes Postgraduate Surgical Examination

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