Optimizing the residency application process: insights from neurological surgery during the pandemic virtual application cycle

Abstract

OBJECTIVE In this article, the authors describe the impact of the COVID-19 virtual match cycle and discuss approaches to optimize future cycles through applicant and neurosurgical education leadership insights. METHODS Anonymous surveys of neurosurgery program leaders (program directors and program chairs), program administrators (PAs), and 2020–2021 neurosurgery residency match applicants were distributed by the SNS, in conjunction with the Association of Resident Administrators in Neurological Surgery and AANS Young Neurosurgeons Committee. RESULTS Responses were received from 77 (67.0%) of 115 PAs, 119 (51.7%) of 230 program leaders, and 124 (44.3%) of 280 applicants representing geographically diverse regions. During the virtual application cycle relative to the previous year, programs received more Electronic Residency Application Service applications (mean 314.8 vs 285.3, p < 0.0001) and conducted more applicant interviews (mean 45.2 vs 39.9, p = 0.0003). More than 50% of applicants applied to > 80 programs; 60.3% received ≤ 20 interview invitations, and 9% received > 40 invitations. Overall, 65% of applicants completed ≤ 20 interviews, whereas 34.7% completed > 20 interviews. Program leaders described one 4-week home subinternship (93.3%) and two 4-week external subinternships (68.9%) as optimal neurosurgical exposure; 62.8% of program leaders found the standardized letter of recommendation template to be somewhat (47.5%) or significantly (15.3%) helpful. Applicants, PAs, and program leaders all strongly preferred a hybrid model of in-person and virtual interview options for future application cycles over all in-person or all virtual options. Ninety-three percent of applicants reported matching within their top 10–ranked programs, and 52.9% of programs matched residents within the same decile ranking as in previous years. CONCLUSIONS Optimizing a national strategy for the neurosurgery application process that prioritizes equity and reduces costs, while ensuring adequate exposure for applicants to gain educational opportunities and evaluate programs, is critical to maintain a successful training system.

Virtual Interviews: Assessing How Expectations Meet Reality

“…While prior authors 18,22,30 have shown survey data or provided recommendations that support or oppose socalled hybrid interviews, most of our respondents opposed this option. Our study's participants worried that hybrid interviews would promote inequities in applicant evaluation without significant benefits.…”

Virtual residency recruitment: future directions in the new era

“…Virtual interviews resulted in a higher rate of matching at a student’s home institution [ 16 , 17 ]. There is evidence that some program directors are concerned that applicants from less prestigious schools are at a disadvantage in the era of virtual interviews and limited away rotations [ 12 ]. Both issues may have a substantial negative influence on diversity, equity, and inclusion, and the critical blending of cultures, both nationally and globally, through the match.…”

Virtual Interviews in Postgraduate Medical Education Recruitment: Is There a Future Post-Pandemic?

“…10,12,22,30,31 Despite these reports, other studies demonstrated that implementation of virtual interviews effectively met overall program and applicant goals without significant differences in interview outcomes, including candidate and program assessment, ranking, and matching. 1,11,20,21,33,41,42 Despite their many limitations, these studies suggest that virtual interviews were generally wellreceived, and both programs and applicants appear to favor a hybrid interview model for the future. 1,9,16,21,22 However, no studies have yet compared hybrid models to in-person-only or virtualonly models.…”

“…1,11,20,21,33,41,42 Despite their many limitations, these studies suggest that virtual interviews were generally wellreceived, and both programs and applicants appear to favor a hybrid interview model for the future. 1,9,16,21,22 However, no studies have yet compared hybrid models to in-person-only or virtualonly models. This could be one area for future exploration.…”

“…Surveys have shown that 40% to 76% of programs across specialties have reported increasing the number of invitations sent out since the virtual interview process. 1,7,11,20,21 Similarly, many candidates also applied to more programs or were less likely to decline interview offers in the year of virtual interviews, compared to prior years, maximizing their chances of matching. 7,22,23 There were over 10% more applications received by programs in the year of virtual residency interviews, 24 although exact effects on trainee match rates are not yet clear.…”