Effects of COVID-19 and the Interview Process for Internal Medicine Residency Applicants

Abstract

Research Question: What was the impact on residency match placement in the 2020-2021 virtual interview cycle compared to the previous years of in person interview cycle Match placements?

Background and Significance: Virtual recruiting of medical students for residency programs was implemented on a national scale at 444 internal medicine residency programs during the 2020-21 application cycle due to the COVID-19 pandemic. For the first time in the National Resident Matching Program (NRMP) Match, applicants ranked programs without having visited their institutions. While residency programs have invested significant time and effort developing virtual interview days, there are undoubtedly components of the interview day that cannot be adequately experienced virtually, such as direct interactions with staff or touring facilities. The lack of in person interactions with programs prior to ranking was likely to affect both applicants and programs in their rank list process. We hypothesized that for the 2020-2021 Match, a larger proportion of applicants matched to the school-affiliated institutions relative to the prior application cycles.

Materials and Methods: Data was aggregated from publicly available websites of Internal Medicine Residency Programs across the United States, obtaining information about the medical school alma mater of each internal medicine resident for the residency graduating classes of 2021-2025. A repeated measures ANOVA was used to determine whether the proportion of individuals who remain affiliated with the same institute for both medical school and residency differs significantly for the 2020-21 application cycle relative to prior years. All data was stored on a password protected computer and on the TCU cloud to be worked on with all research team members.

Results: Initial analysis of a convenience sub-sample of residency programs indicates that fewer medical students who interview virtually are staying at internal medicine residency programs affiliated with their alma mater than did when interviewing occurred in person. However, there was a statistically significant increase in the number of matriculants that stayed in the same state and region as their medical school.

Conclusion: Much attention has been paid to the social inequity that resulted as medical students, on top of the debt for their education, were required to spend thousands of dollars traveling for residency interviews. We posited that students, unable to travel and visualize alternative residencies, would decide to match in the school and hospital systems that they knew. Instead, we find that, in internal medicine, the ability to visit virtually has led to increased choices and a decrease in the number of students matching locally. We posit that the increase in applications, possibly due to the decreased travel costs, may demonstrate a willingness on the part of students to actively consider a broader range of programs that would previously have been out of reach due to financial constraints. Further studies should determine whether this is replicated in other specialties, and whether the effect is more pronounced in economically disadvantaged students.