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    Interviews in GME: Where Do We Go From Here?

    Before 2020, most residency and fellowship programs wouldn’t have considered conducting their selection process virtually. Then, the world changed, and programs rose to the challenge. With innovation, creativity, and open minds, graduate medical education (GME) was collectively able to effectively adopt virtual interview formats. Now, in the post-COVID-19 era, institutions have a choice between interview formats that each have pros and cons. So where do we go from here?

    The AAMC recommends that residency and fellowship programs use a virtual interview format. Reducing the cost of interviewing is a critical step in widening access and improving equity. In addition, initial, specialty-specific studies1,2,3 indicate that applicants prefer virtual interviews and virtual interviewing is consistent with the commitment academic medicine has made to reduce our environmental impact.

    Every program has their own unique mission, goals, and context, and thus may take different approaches for sound reasons. We recognize that what is best for one program may not be best for another. Each institution should evaluate the pros and cons of interview formats in their unique context to determine what is best for their program and/or specialty.

    As you decide what interview format is best for your institution, we have summarized five key considerations for review. Table 1 then summarizes reasons why you might choose one format over another and steps for success for each format.

    Key Consideration 1: The financial costs associated with interviewing for medical school and residency or fellowship programs are high.

    According to applicant surveys, the costs associated with interviewing are an expensive aspect of the application process.4 While every applicant’s situation is unique, these costs can range from hundreds to thousands of dollars. Financial constraints can be a barrier that prevents applicants from interviewing, especially learners from lower socioeconomic backgrounds. This barrier can be mitigated through virtual interviews, a hybrid option for applicants who need flexibility, or offering financial support for in-person interviewing.

    By widening access and decreasing financial barriers, virtual interviews may increase visibility and potential connections to applicants who might not have previously considered your program .

    “Interviewing virtually saved me thousands of dollars. I honestly don’t know how residency applicants used to pay for airfare and accommodations for each interview. I had seven interviews in the state of Florida, and none of them were back-to-back. Had interviews been in-person, that would have meant seven separate trips to and from Florida. Not to mention that my medical school was not centrally located or near a major airport which made travel to and from more difficult.”

    Brett Riddle, ERAS 2020 applicant

    Key Consideration 2: Most applicants prefer virtual interviews.

    The AAMC conducted focus groups in early 2023, during which residency applicants emphasized that virtual interviews reduced travel time and cost and therefore were considered the favorable format. In one survey of applicants, respondents indicated that overall, they found the virtual interview experience to be positive, noting that the most beneficial aspect of interviewing virtually was the cost savings on travel but additionally citing the comfort and ease of being able to interview in a familiar space, therein reducing their stress and calming interview day nerves.3

    “I am thankful I got to interview virtually. It saved me a substantial amount of money and realistically allowed me to interview at more places. I even had the opportunity to interview at two places on the same day (morning and afternoon). This allowed me to take less time off from rotations which I know my preceptors appreciated.”

    Sarah Lowen, ERAS 2020 applicant

    Key Consideration 3: Time spent away from school, work, or other commitments due to travel associated with in-person interviews is an undue burden for applicants to bear.

    In addition to being financially taxing, interviewing is notably a time-consuming part of the selection process. Travel associated with in-person interviews is a burden with varying levels of stress and has the potential to limit the opportunities available to applicants depending on their socioeconomic status, family structures, social networks, etc. For residency applicants, virtual interviews reduce time away from developing valuable clinical skills and competencies many residency program directors expect at entry to residency. In a survey of applicants applying to plastic surgery residency programs, over 70% of applicants missed seven or more days of medical school to attend in-person interviews.5

    “As interview ‘season’ has expanded to cover several months of the M4 year, it is increasingly challenging for students to be able to interview with an adequate number of programs while also fulfilling the course and elective requirements for medical school graduation. Virtual interviews provide more flexibility for medical students to work around their clinical schedules and also reduce the time away from clinic since there is no associated travel burden. This also allows students greater time and opportunity to not only maintain but also further develop their clinical skills.”

    Marcy Verduin, Associate Dean of Students at the University of Central Florida College of Medicine

    Key Consideration 4: Separating assessment and recruitment efforts is an important step to mitigate risk of bias in interview ratings.

    Applicants want to learn about programs and their communities to understand and appreciate culture and fit. And we know that programs wish to welcome applicants to their campuses and communities for the same reasons. Applicants can get to know your program and community, while reducing cost, by utilizing virtual resources and activities.

    As a best practice, assessment activities, such as the interview, should be conducted separately from a program’s recruitment efforts to ensure that interactions outside the interview do not introduce bias or irrelevant information into your interview evaluation or final decision-making process.

    For optional in-person events offered, we suggest considering whether your institution can offer stipends to offset the cost of travel and accommodations, to make in-person events more accessible.

    Key Consideration 5: Medical schools, teaching hospitals and health systems, and the AAMC have made commitments to reduce their carbon footprints.

    The health care sector is responsible for 8%-10% of greenhouse gas (GHG) emissions in the United States and a quarter of all global GHG emissions. Academic medicine, whose mission is to improve the health of people everywhere, makes a major contribution to the climate crisis — the greatest health threat of the 21st century — and therefore has an important role to play in resolving it.

    Increasing options for virtual interviews offers the opportunity for academic medicine to focus on sustainability by reducing our community’s carbon footprint. Early studies6,7,8 support that virtual interviews have the potential to reduce the climate impact of academic medicine.

    Table 1. Reasons you might choose one interview format over another and steps to success for each.

    Interview Format Reasons You Might Choose an Interview Format Steps to Success
    Virtual Only
    • Many applicants are out-of-state or require travel.
    • Commitment to reducing carbon footprint. 
    • Flexibility in scheduling. 
    • Offer virtual recruiting activities to all applicants.
    • Develop technology standards and training for faculty conducting virtual interviews.
    Hybrid (i.e., an applicant can select either in-person or virtual interviews)
    • Mix of local and out-of-state applicant pool.
    • Need to showcase less well-known or rural area.
    • Flexibility in scheduling.
    • Gives applicants and faculty choice.
    • Implement policies, procedures, and interviewer training to ensure standardization across formats and to mitigate risk of bias.
    • Ensure admissions/selection committees are blinded to interview format.
    • Inform applicants about steps taken to make the hybrid approach equitable.
    • Offer virtual recruiting activities to all applicants.
    In-Person Only
    • Most applicants are not out-of-state or do not require extended travel plans.
    • Need to showcase less well-known or rural area.
    • Offer financial support to applicants who may need it for travel.


    1. Bishop T, Heinrich L, Greenberg JB, Wenner R, Furst W, Wong J. The impact of virtual interviews on the resident candidate: a before-and-after comparison. Fam Med. 2022;54(10):833-835. doi: 10.22454/FamMed.2022.510274. 
    2. Huppert LA, Hsiao EC, Cho KC, et al. Virtual interviews at graduate medical education training programs: determining evidence-based best practices. Acad Med. 2021;96(8):1137-1145. doi: 10.1097/ACM.0000000000003868. 
    3. Lee E, Terhaar S, Shakhtour L, et al. Virtual residency interviews during the COVID-19 pandemic: the applicant's perspective. South Med J. 2022;115(9):698-706. doi: 10.14423/SMJ.0000000000001442. 
    4. AAMC. The cost of interviewing for residency. https://students-residents.aamc.org/financial-aid-resources/cost-interviewing-residency. Published Dec, 28, 2022. Accessed March 10, 2023. 
    5. Susarla SM, Swanson EW, Slezak S, Lifchez SD, Redett RJ. The perception and costs of the interview process for plastic surgery residency programs: can the process be streamlined? Plast Reconstr Surg. 2017;139:302e–309e. doi: 10.1097/PRS.0000000000002912.
    6. Dzau VJ, Levine R, Barrett G, Witty A. Decarbonizing the U.S. health sector — a call to action. N Engl J Med. 2021;385(23):2117-2119. doi: 10.1056/NEJMp2115675. Epub 2021 Oct 13. PMID: 34644470.
    7. Domingo A, Singer J, Cois A, et al. The carbon footprint and cost of virtual residency interviews. J Grad Med Educ. 2023;15(1):112-116. doi: 10.4300/JGME-D-22-00229.1. PMID: 36817522; PMCID: PMC9934836.
    8. Hampshire K, Shirley H, Teherani A. Interview without harm: reimagining medical training's financially and environmentally costly interview practices. Acad Med. 2023;98(2):171-174. doi: 10.1097/ACM.0000000000005000. Epub 2022 Sep 27. PMID: 36696296.

    We would like to thank our UME and GME Interview Working Group Members for their continued and valuable input with developing the AAMC’s recommendations for interviews moving forward. Our working group includes representatives from both UME and GME, as well as a medical student and prehealth advisor:

    Name School/Association Role
    Liesel Copeland, PhD Director, Admissions and Medical Education
    Rutgers Robert Wood Johnson Medical School
    Group on Student Affairs Committee on Admissions
    Jason D’Antonio Director, Health Professions Program
    Carnegie Mellon University
    AMCAS Advisory Committee
    Prehealth Advisor
    Michael Dell, MD Division Chief, Pediatrics
    University Hospitals Rainbow Babies and Children’s Hospital
    Professor, Pediatrics
    Case Western Reserve University School of Medicine
    Residency Specialty Program Director
    Judianne Kellaway, MD Associate Dean, Admissions and Outreach
    University of Texas Health Science Center at San Antonio Joe R. and Teresa Lozano Long School of Medicine
    Group on Student Affairs Committee on Admissions
    Dori Marshall, MD Director of Admissions and Associate Dean
    Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
    Medical School Admissions Officer
    Mary Nguyen University of Arizona College of Medicine - Tucson Medical Student
    Adena Rosenblatt, MD PhD Director, Dermatology Residency Program
    Assistant Professor of Pediatric Dermatology
    University of Chicago Pritzker School of Medicine
    Residency Specialty Program Director
    Christin (Chrissy) Spatz, MD Director of Clinical Advising
    Geisinger Commonwealth School of Medicine
    Medical School Advisor
    Marc Thorne, MD Clinical Professor, Otolaryngology
    University of Michigan Medical School
    Residency Specialty Program Director

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