Interviewing Otolaryngology Applicants in a Virtual Setting: A Perspective After 2020 to 2021 Match

Following the onset of the COVID-19 pandemic, in-person visiting rotations and in-person interviews were canceled in accordance with social distancing guidelines. ¹ All interviews were conducted virtually. Since the COVID-19 vaccine rollout, the Association of American Medical Colleges has recommended in-person sub-internships be resumed starting August 2021. ² Nonetheless, a growing number of specialties have already announced their intentions to continue strictly virtual interviews through the upcoming residency application cycle, but there is no consensus to date regarding how Otolaryngology residency programs will interview their applicants. ^{3 -5} As the Centers for Disease Control and Prevention loosen mask requirements and the number of fully vaccinated Americans rises, the necessity of continuing interviews in a virtual setting has been debated. ^{6 -8} Reinforcing disease prevention strategies is a priority among the medical community. However, it is unclear if last year’s virtual interactions were effective in evaluating applicants. Therefore, we reviewed the available literature regarding virtual interviews and distributed a survey to Otolaryngology program directors to evaluate the quality of virtual interviews and their utility for prospective residency application cycles.

A Qualtrics XM survey consisting of multiple-choice and open-ended questions was distributed to all 124 Otolaryngology residency program directors in the United States on May 7, 2021, by email. The survey was closed on June 4, 2021. A comprehensive list of the survey’s questions can be seen in the supplemental document (Survey Questions). Of 124 residency program directors emailed, we had a response rate of approximately 14.5% with the completion of 18 surveys. Most (78%) believed applicants were not fully experiencing their residency program when adopting a fully virtual format. A third (33%) believed virtual interviews limited their program’s ability to evaluate applicants, 33% were “unsure” and 33% did not consider the virtual platform a limitation. To supplement limited in-person interaction, 94.4% offered virtual opportunities outside of interviews including open houses and Q&A sessions. Half (50%) of respondents plan to continue these preinterview virtual opportunities for future cycles to advertise their program, even when in-person interactions return.

Despite this unprecedented global event, preliminary match rates for surgical specialties, including Otolaryngology, appear similar to pre-pandemic rates. ⁹ However, it remains unclear what lasting implications these virtual formats will have on future residency application cycles. Kasle et al previously surveyed Otolaryngology program directors during the onset of COVID-19. Their results indicate that most Otolaryngology program directors speculated that virtual interviews would be “insufficient in providing a comprehensive assessment of candidates” and our results support this perspective. ¹ This aligns with previous data surveying both students and residents (n = 1824 respondents) demonstrating that in-person interviews, despite distance and travel expenses, are favored over virtual interviews. ⁶ This opposes the notion that virtual interviews are more favored by applicants since they are more accessible and affordable. ^7,8 Applicants approaching 2020 to 2021 interviews felt less confident matching and more limited obtaining residency program information in a virtual setting and therefore planned to interview and apply more broadly. ¹⁰ A large research brief (n = 8901 respondents) surveying both applicants and program directors representing all specialties suggests that virtual experiences did not significantly affect the application process or interviewing behaviors. ⁸ Most respondents did not feel limited by technical difficulties. However, applicants felt a significant disadvantage assessing program culture, personality, and strengths through this milieu. And more than half of applicants preferred in-person interviews with only 20.7% preferring a virtual format. Regarding virtual opportunities offered outside of interviewing to advertise residency programs, our data suggest that these novel approaches could persist, calling into question the implication of a hybrid model in prospective application cycles.

Of note, the emergence of the COVID-19 Delta variant is currently a growing concern as it spreads across the United States. At this time, it is unclear what impact this variant may have on the residency application cycle. It is possible that residency programs will continue virtual interviews as a direct response to these changes. Continuing disease prevention strategies among the medical community is a priority. As these events unfold, Otolaryngology residency programs should respond appropriately while attempting to preserve the integrity of the interview process. Unfortunately, our preliminary survey is limited by a low response rate (14.5%), subjecting this study to nonresponse bias. A higher response rate would render a more accurate perspective, and it is possible that our nonrespondents differ significantly in their opinions. Therefore, we performed a literature review to provide a more comprehensive outlook. Nonetheless, both our preliminary survey and literature review suggest that Otolaryngology applicants and program directors feel this virtual format is not an ideal surrogate to evaluate applicants despite the recent decisions of other specialties to continue strictly virtual interviews. The impact that the COVID-19 Delta variant will have on this upcoming interview season is unclear and better defining expectations will benefit both Otolaryngology residency programs and applicants alike.

Supplemental Material

Supplemental Material, sj-pdf-1-ear-10.1177_01455613211040377 - Interviewing Otolaryngology Applicants in a Virtual Setting: A Perspective After 2020 to 2021 Match

Supplemental Material, sj-pdf-1-ear-10.1177_01455613211040377 for Interviewing Otolaryngology Applicants in a Virtual Setting: A Perspective After 2020 to 2021 Match by Andrew B. DeAtkine, Paul F. Chisolm, Nikhi P. Singh, Connor G. Koch, Timothy W. King, Benjamin J. Greene and Erin P. Buczek in Ear, Nose & Throat Journal