Radiology Residency Match: The Cost of Being in the Dark

Virtual Interviewing for Radiology Residency: Pluses, Minuses, and A Review of the Literature

This article reviews current medical literature to assess the benefits and drawbacks of virtual interviews for radiology residencies as well as the downstream effects of these changes, best practices, and potential future recruitment methods. Topics covered include the effects of remote recruitment in promoting accessibility and applicant diversity and equality as well as fiscal, environmental, and time savings in combination with technical challenges, the complications of over application, challenges in assessment of program culture and location, impact on morale, and hidden financial and emotional costs. Learnings from other medical specialties are highlighted in addition to the process of signaling, guidelines for conducting and participating in virtual interviews, and matters for future consideration.

COVID-19 Increased Residency Applications and How Virtual Interviews Impacted Applicants

Background

The number of residency applications submitted by medical students has risen at an alarming rate, causing increased cost of applications and subsequent interview travel. These both contribute to increased cost for medical students. In light of these concerns, specialty governing bodies have proposed ideas to fight these trends including, application limits, interview limits, using a preference signaling system, and continuing virtual interviews. During the Covid-19 pandemic, all residency interviews were performed virtually, essentially making travel expenses negligible. However, this created a new concern with regards to assessing program and applicant compatibility, as compared to in-person interactions and did nothing to combat the increases in application numbers. Therefore, we want to critically assess the effects of virtual interviews on number of applications submitted, number of interview invites received, and number of interviews attended. We also aim to analyze how applicants viewed the virtual process.

Methods

600 medical students were eligible to participate. 456 students from years 2018-2020 were eligible to be surveyed following the NRMP match. 144 students were eligible to be surveyed following 2021 NRMP match. The survey was distributed to medical school graduates just prior to graduation and asked how many programs each student applied to, how many interview invites they received, and how many interviews they attended. The 2021 survey also asked, “How did virtual interviews affect your interview experience?” The quantitative results were compared with student's t-test and qualitative results are presented below. 

Results

The average number of programs each applicant applied to increased from 35.4 to 47.7 (p-value=0.002) when residency interviews switched from in-person to virtual. However, interview invites received and interviews attended did not change (16.8 vs 16.3, p-value=0.91, 11.8 vs 12.7, p-value=0.18). There were 188 participants in the in-person interview group (response rate=41.2%) and 128 participants in the virtual interview group (response rate=83.3%). The standard deviation and range also increased for number of applications, number of interview invites received, and number of interviews attended. 

There were 123 responses to the free response question. 36 had a positive experience, 44 were neutral, 47 were negative. The positive themes included 15 noted less expenses, 18 noted more convenient/less time, and 18 were able to attend more interviews. Negative themes included, 38 noted difficulty assessing program fit, 19 wanted to see the program or city in person, eight had increased interest in home/local programs, six found it difficult to make connections or stand out. 

Conclusion

Sixty-three percent of students reported a positive or neutral experience with virtual interviews. Students applied to more programs when interviews were virtual, but did not receive more interview invites or attend more interviews. These results suggest that virtual interviews are sufficient to conduct residency interviews, however the number of applications continues to rise with no increase in the number interview invites received or number of interviews attended. The increase in the standard deviation and range for all three variables may point to some applicants being able to get more invites and attend more interviews leaving less available spots for other applicants. 

Analysis of 10 Years of Diagnostic Radiology Match Data: Notable Changes and Their Potential Implications

RATIONALE AND OBJECTIVES

Identification of shifts in match metrics, such as applicant volumes, match rates, and interview patterns, stands to inform and empower both applicants and programs participating in the NRMP residency match. Residency programs rarely publish their internal data. Accordingly, we employed publicly available resources to evaluate changes in such metrics for the diagnostic radiology match from 2008 to 2018.

MATERIALS AND METHODS

Reports made available to the public by the NRMP, alongside student discussion on the AuntMinnie.com and StudentDoctor.net forums, were used to determine applicant volumes, interview volumes, program rank-order-list metrics, match rates, and interview invite patterns. Linear regression and correlation analyses were employed to identify statistically significant trends.

RESULTS

No statistically significant trends were identified across the selected timeframe for applicant volumes or match rates. Statistically significant upward trends were identified for total interview volumes, average interviews attended per applicant, and the fraction of programs inviting students to interview before October 1st, the MSPE release date (p < 0.05). A very strong and significant positive correlation was identified between average interviews attended per applicant and the average number of ranks needed by programs to fill a position (p < 0.01, R = 0.804).

CONCLUSION

Applicants pursuing a diagnostic radiology residency are attending more interviews, and programs are increasingly inviting students to interview based on incomplete applications. However, there has been no corresponding uptrend in match rates. Moreover, increased applicant interview attendance is highly associated with programs falling further down their rank lists. Given the expenses usually associated with the match process and forthcoming changes to USMLE scoring, these trends may be unsustainable.

Analyzing the Landscape of the 2021 Virtual Match: A Nationwide Survey of Radiology Programs' Stakeholders

RATIONALE AND OBJECTIVES

We aimed to provide insights into the adaptive strategies, benefits, and challenges faced by the radiology programs during the 2021 residency virtual Match. Furthermore, we explored the potential impacts of related topics, such as diversity and social media use on the Match process and outcomes.

MATERIALS AND METHODS

A cross-sectional survey of 31 questions was designed and distributed via e-mails to individuals involved radiology programs match process during the 2021 Match. Descriptive statistics were used to analyze the results of most questions. Two questions comparing the changes in factors influencing the selection of applicants on a Likert scale of 1-5 were analyzed using paired t-test and Wilcoxon signed-rank test where p-value <0.05 was considered statistically significant.

RESULTS

Responses from 125 participants were analyzed. The following factors carried less weight in evaluating applicants during 2021 Match: away rotations (p < 0.01), no failed attempts in USMLE Step 1/CK (p < 0.01), grades in radiology clerkship (p < 0.04), and class rank/quartile (p < 0.04), while personal statements were more important (p < 0.03). Out of the 125 respondents, 80 (64%) and 58 (47%) strongly or somewhat agree on the effectiveness of virtual interviews in gauging applicants' candidacy and showing their programs' advantages, respectively. Advantages of virtual interviews included decreased cost, time flexibility, less faculty burden, and an increased number of offered interviews according to 81% (101/125), 46% (58/125), 40%, (50/125), and 34% (43/125), respectively. The most helpful platforms that showcased program advantages were program websites followed by Twitter and Instagram.

CONCLUSION

Most radiology programs were able to adjust to the virtual interview process, and the majority agree on their effectiveness citing many benefits. However, there were mixed opinions if it could be sustained in future cycles.

The Impact of a Virtual Radiology Medical Student Rotation: Maintaining Engagement During COVID-19 Mitigation

Introduction

The purpose of this study is to introduce a virtual radiology rotation curriculum that is being used to safely maintain medical student and intern education and engagement with the Department of Radiology at Walter Reed National Military Medical Center during coronavirus disease 2019 (COVID-19) mitigation.

Materials and Methods

The curriculum is designed as a 4-week block with each week representing one of the four highest yield radiology subspecialties for medical students; neuroradiology, thoracic radiology, body radiology, and musculoskeletal radiology. A subspecialist radiologist from each section was identified as a primary mentor and tasked with designing a daily schedule for medical students and interns. The first 2 months of virtual rotators were surveyed to assess the effectiveness of the course.

Results

Thirty-five of 41 rotators responded to the survey, a response rate of 85%. Thirty-one of 35 (89%) of the rotators gave this virtual elective rotation a positive rating, with 16 trainees scoring the course as 4 out of 5 and 15 trainees selecting 5 out of 5. Four respondents selected 3 out of 5. Five out of 5 respondents who had experienced an in-person radiology elective rotation before this virtual rotation rated the virtual elective as more educational than the in-person rotation. We found the 4-week subspecialist mentor-based structure to be highly versatile, allowing us to simultaneously accommodate multiple groups of full or partial block rotators throughout COVID-19 mitigation.

Conclusion

A virtual rotation curriculum is a viable method of maintaining medical student and intern education and engagement with the department of radiology during COVID-19 mitigation.