LAUSR

Due to the COVID-19 pandemic, the annual National Resident Matching Program (NRMP) fellowship match [1] has transitioned to virtual interviews for the current recruitment season [2, 3]. An excellent article by Dr. Mallepally and colleagues outlines recommendations for thoughtful implementation of this major change, describing challenges faced by both applicants and fellowship programs [4]. The authors of this letter had personal experience with virtual interviews in 2018, prior to the pandemic. This experience provided early insight into challenging aspects of virtual interviewing: conveying a program’s culture and assessing the intangible quality of “fit.” An important way to determine the mutual fit of a program is to create a meaningful connection between applicants, fellows and faculty. This was possible in the virtual space, but did require creativity. For example, one program arranged for meeting fellows in an informal setting. Another program’s coordinator gave the applicant a live virtual department tour by walking with an iPad. To help a diverse set of applicants to visualize themselves in a program, it is important to involve faculty and fellows from different backgrounds. Programs can help applicants envision living in a city by including videos or presentations about the surrounding area. Programs can also build on these resources and convey a sense of inclusivity by describing neighborhoods, affordability, and childcare opportunities. Many intangible criteria utilized by programs in rank list decisions can work against members of underrepresented groups. Providing anti-bias training for interviewers is helpful [5]. Coordinating and requiring interviewers to use behavioral interviewing questions can reduce implicit bias between applicants. Additionally, program directors have reported that the most important factors when ranking candidates are interview interactions, interpersonal skills, and professionalism [6]. While the article by Dr. Mallepally et al. highlights recommendations on how to demonstrate professionalism in a virtual interview (including attention to an interviewee’s physical space, lighting, and noise), program directors must remember that many applicants are now often interviewing in non-traditional circumstances. Applicants may have children around the home who are unable to attend daycare or school. Socioeconomic disparities exist between applicants who can afford quiet, well-lit spaces at home, and those who need to use hospital space. Lack of access to certain resources or spaces should not be construed as indicative of performance during fellowship. Professionalism standards are important, but should not disadvantage certain socioeconomic, cultural, racial, and ethnic groups— conducting interviews through the lens of mitigating bias for underrepresented applicants is essential [7, 8]. Indeed, a potential benefit to this new virtual process is reducing travel expense inequities as a barrier to enter the field [9, 10]. Both applicants and program directors should go through this new virtual interview process with the expectation that “glitches” will occur, and do not necessarily reflect on a program’s ability to provide excellent training, or an applicant’s ability to be an outstanding fellow. We believe the future of fellowship recruitment will involve some hybrid model of in person and virtual interviews. As this may become the new norm, it is important we continue to refine the process.