Reply: Interview Disparity following the Implementation of Virtual Interviews.

Abstract

We greatly appreciate Chisolm and colleagues’ thoughtful insight regarding our article discussing potential interview disparities for integrated plastic surgery applicants following the implementation of virtual residency interviews during the COVID-19 pandemic.1 As we know, the COVID-19 pandemic has had a profound impact on patient care, medical training, and the resident selection process.2–4 Virtual interviews, in particular, were a significant transition for applicants and programs alike with regard to evaluation, cost, and interview logistics. Decreased interview-related costs incurred by applicants and reduced travel during the application cycle are among the greatest benefits offered to applicants; however, it has also raised concerns about interview hoarding by top-tier applicants.1,5 Our article determined that a plausible solution to interview hoarding is to limit the number of interviews each applicant can accept based on the National Resident Matching Program data.1 We agree that increasing the number of interview invitations offered to applicants, as proposed by Chisolm and colleagues, could theoretically increase the chances of less-competitive applicants matching into an integrated plastic surgery residency. Before the pandemic, applicants could gain exposure to programs of interest through subinternships and away rotations, which provided familiarity with programs of interest.2 Rotations are currently limited mainly to an applicant’s home institution, resulting in greater reliance on objective metrics for applicants who lack a connection to programs of interest.3 Increasing interview invitations could ameliorate barriers for many applicants who lack the quantifiable metrics of top-tier applicants. Furthermore, increasing the number of interviews would likely not affect stellar applicants’ chance of matching into a residency position. Despite these potential benefits, expanding the number of applicant interviews is not without drawbacks. Most notably, interviewing more applicants necessitates that residents and faculty spend more time away from their clinical duties, which comes at the expense of valuable training and department revenue. In addition, expanding the residency interview pool may result in applicants hoarding more interviews than in previous application cycles, given that more interviews may be needed to match. Providing more interview spots for applicants may not be sufficient to increase their odds of matching, since subjective assessment of applicants is limited using the virtual interview format.2,3 Taking these factors into account, extending more interview invitations is likely a disservice to both programs and applicants. Expanding the interview pool can increase applicant exposure to programs; however, we suspect it will not have the desired result on match outcomes. Going into the 2022–2023 residency application cycle, program directors must be vigilant in inviting a diverse pool of applicants and reinforce the importance of a holistic approach to evaluating and ranking applicants, given that none of the outlined solutions have been implemented. We are optimistic that the lessons learned from the 2020–2021 and 2021–2022 application cycles will improve the selection process moving forward; however, the degree of improvement remains to be seen. Andrew E. Grush, B.S.Andrew M. Ferry, M.D.Division of Plastic SurgeryMichael E. DeBakey Department of SurgeryBaylor College of MedicineDivision of Plastic SurgeryDepartment of SurgeryTexas Children’s HospitalHouston, Texas Malke Asaad, M.D.Department of Plastic SurgeryUniversity of Pittsburgh Medical CenterPittsburgh, Pa. Aashish Rajesh, M.B.B.S.Department of SurgeryThe University of Texas at San AntonioSan Antonio, Texas Renata S. Maricevich, M.D.Division of Plastic SurgeryMichael E. DeBakey Department of SurgeryBaylor College of MedicineDivision of Plastic SurgeryDepartment of SurgeryTexas Children’s HospitalHouston, Texas