In a normal year, the residency-selection process is anxiety-provoking. Adding a global pandemic to the mixresulting in key aspects of the process being alteredmay deepen those anxieties.

A recent webinar in the AMA Innovations in Medical Education Webinar SeriesResidency Application Process: Current Challenges and Potential Solutionsexamines some of the typical challenges of residency selection and how they might be addressed during the atypical 2021 application cycle and beyond. A recording of the webinar is available in the resources area of theAccelerating Change in Medical Education Community(registration required).

Even in normal times, the process of finding a residency program can be taxing on students. As highlighted by Kathleen Kashima, PhDsenior associate dean of students at University of Illinois College of Medicinethis years cycle could add greater uncertainty to the process of distinguishing among residency applicants. Some of the milestones that are traditionally part of the process, such as away rotations, also have fallen by the wayside due to travel restrictions.

According to Kashima, areas disrupted by the pandemic include:

Because of these and other uncertainties, medical students application behaviors may change this year.

We are encouraging student applicants to apply to programs that they see as a good fit and not flood the zone with applications, Kashima said. Find out how residency programs will view applications in 2021.

Competitive specialties and prestige programs may get more applications. More students than usual may choose to do joint degrees and research programs, which will increase the number of applications next year. There are some groups of students who have more angst and may apply to more programs.

Despite those potential realities for the upcoming cycle, Kashima cited reasons for optimismincluding the quick responses stakeholders made to accommodate this years Matchon a community movement toward a healthier Match culture.

Learn about a pilot program that offers residency applicants a chance to say, Look at me.

Citing a lack of interest among applicantsand program directors, the Association of American Medical Colleges (AAMC) announced that a video interview program it had been pilotingfor emergency medicine residency programs would not continue past the 2020 application cycle.Still, the experience some faculty programs had with the standard video interview (SVI) program could inform the upcoming cycle of virtual interviews, said Fiona Gallahue, MD.

Dr. Gallahue cited research on the now defunct SVI program offers some insight on student preparation habits that is likely applicable to the upcoming virtual interview cycle. Data cited from a 2018 study shows that:

There are some take-home points from the SVI, said Dr. Gallahue, director of the emergency medicine residency program at the University of Washington. One is that its possible that unconscious bias can be limited and maybe even eliminated in an interview setting if enough time and resources will be applied. At least 10% of our applicants will have technical difficulties, so its best to offer a plan B and maybe even a plan C.

A majority of our applicants will be doing the interviews in their homes, so that they can be in a comfortable environment, she added. Certainly, it makes sense to encourage that. Students will likely prepare for these interviews better if they are given materials in advance, coaching and have expectations set. I really dont think we want anyone preparing more than seven hours.

Learnwhy the AAMChaltedthe standardized video interview.

In 2010, 18% of student applicants from U.S. MD-granting medical schools matched with a school they ranked fourth or lower on their list. In 2020, that number was at 24%. Maya M. Hammoud, MDchair for education at University of Michigan Medical Schooloffered that data as evidence that the Match is becoming less efficient with the increasing number of applications.

To help with efficiency, she offered three proposed approaches:

The third measure is one which Dr. Hammoud is pursuing via a grant from the AMA Reimaging Residency initiative grant. The projectRight Resident, Right Program, Ready Day Oneaims to improve the continuum of education between medical school and residency. The project strives to optimize the alignment and compatibility between interested applicants and potential residency programs.

We all want the same thing, Dr. Hammoud said. We all want the cycle to be a lot better and we are all working to make it the best it can be. But, clearly, the current status is not acceptable. We all can see it deteriorating year after year and we cant just stand by and watch.

Learn how ob-gyns are aiming to fix residency selection.

The AMA has curateda selection of resourcesto assist residents, medical students and faculty during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events at this time.

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How to confront the challenges of an unprecedented Match cycle - American Medical Association