The coronavirus disease of 2019 pandemic has exerted a significant impact on all aspects of daily living, including medical education. In accordance with the guidelines issued by the Association of American Medical Colleges, the American Council of Academic Plastic Surgeons “supports the expectation that all plastic surgery programs commit to online interviews” for the 2020/2021 academic year.1–4 This new interview format would be applicable to all (including local) applicants, to limit bias in resident selection and ranking.4
An unexpected but dire consequence of the transition to virtual interviews is the disparity in the number of interviews among applicants. In 2019, out of 78 available plastic surgery programs, senior allopathic students who matched applied to a median of 76 programs (97 percent).5 Historically, for those stellar applicants who received more than 15 interviews, the time constraint imposed by in-person interviews served as a limit on the number of interviews one could attend.5,6 For example, senior allopathic students who matched into plastic surgery in 2019 received a median of 21 interviews and attended a median of 15 interviews, compared to a median of seven invited and attended interviews for their nonmatching counterparts.5
However, with the advent of virtual interviews, this barrier is removed. Applicants can now interview for a program on the West Coast in the morning and another program on the East Coast later the same day. Without the time and burden of cost serving as a ceiling for interview numbers, qualified applicants can be expected to accept most, if not all, interview invitations. However, programs may not be able to increase the number of interviews they can offer. Ultimately, this may culminate in severe consequences for some of the less-competitive applicants, especially those without home plastic surgery programs, who will now likely receive fewer interviews due to this effect.6 Consequently, programs may not fill through the main Match, as most programs would choose to interview stellar applicants who are likely to match higher up their rank list.
There are two potential solutions to this problem. The first option is to limit the number of applications per applicant. However, without knowing the number of interview invitations an applicant will receive, this may still lead to disparity in the number of interviews, which can impact the applicant’s chances in matching. The second solution, arguably a more tenable approach, is to place a limitation on the number of interviews an applicant can accept. The ideal number of interviews should be specialty specific. To assess this number in plastic surgery, we analyzed the number of contiguous ranks from the National Resident Matching Program data from the years 2007 through 2018, which is reflective of the number of attended interviews.7,8 This number has increased across the years (Table 1). In 2018, the mean number of contiguous ranks was 13.7 for matching senior allopathic students and 6.8 got their nonmatching counterparts. By analyzing the relationship between matching and number of contiguous ranks, one can infer that 12 interviews yield a 90 percent chance of matching, 15 interviews yield a 95 percent of matching, while 20 interviews approach 100 percent. Therefore, a limit of attended interviews between 15 and 20 interviews would be enough to secure a plastic surgery position and offer less-competitive applicants a real chance to match. This limit could be enacted through the Association of American Medical Colleges by issuing a limited number of tokens to accept interviews through the Electronic Residency Application Service application.
Table 1.
Median Number of Contiguous Ranks
| Year | U.S. Senior Allopathic Students | Nonsenior Students | ||
|---|---|---|---|---|
| Matched | Unmatched | Matched | Unmatched | |
| 2007 | 7 | 2 | 2 | 1 |
| 2009 | 9 | 3.9 | 3.6 | 2.6 |
| 2011 | 10.7 | 6.5 | 3.3 | 4.3 |
| 2014 | 8.6 | 4.1 | 3.1 | 2.1 |
| 2016 | 12.6 | 5.9 | 1*/3.3† | 3*/5.8† |
| 2018 | 13.7 | 6.8 | 5† | 4.7† |
| Overall | 10.6 | 4.8 | 3.1 | 2.9 |
U.S. international medical graduate.
Non-U.S. international medical graduate.
Virtual interviews may result in disparity in the number of interviews among applicants. Placing a limitation on the number of interviews an applicant can accept is a potential solution to this problem. This number could be based on the Match data from previous years and should be specialty specific.
DISCLOSURE
The authors have no financial interest to declare in relation to the content of this article.
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REFERENCES
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