The lasting impact of virtual interviews on surgical fellowship applicants

Abstract Purpose Surgical fellowship interviews shifted to a virtual platform in 2020 due to the COVID-19 pandemic. While virtual interviews provide convenience, they also pose difficulties for programs and raise potential barriers for applicants. This study compares in-person to virtual interviews and characterizes the impact on programs and applicants. Methods In-person (2007–2019) and virtual (2020–2022) fellowship application data were extracted from publicly available NRMP Specialties Matching Service data. Fellowship programs included surgical critical care, surgical oncology, colorectal, pediatric, thoracic, and vascular surgery. Competitiveness was assessed using a validated normalized competitiveness index (NCI). Results Since virtual interviews, rankings per applicant, a surrogate for program interview workload, increased for all fellowships except pediatric surgery. The most competitive subspecialties now include colorectal, pediatric, and thoracic surgery. For non-US MDs in these subspecialties, applicants per position decreased (pediatric), match rate decreased (thoracic), and NCI increased (thoracic) under virtual interviewing. However, for the least competitive subspecialties, non-US MDs had increased rankings per applicant (critical care and vascular), increased match rate (critical care and surgical oncology), and decreased NCI (surgical oncology) with virtual interviewing. Conclusions Since the virtual platform was implemented, applicants have interviewed at and ranked more programs, subsequently increasing program workload. While this is positive for many applicants, a differential pattern of securing a fellowship emerged for non-US MD applicants. This finding is important for fellowship program directors to consider and ensure non-US MD applicants are not marginalized with the virtual platform. Level of Evidence III