Ethical issues related to the virtual interviews process faced by applicants and programs.

, This will reduce barriers that previously prevented applicants from overaccepting interviews and may result in saturation of interview slots with top-tier applicants, leaving other applicants with few or no interviews and potentially resulting in unmatched positions. What can programs do to prevent this scenario?

—Concerned Program Director

This is challenging, because we do not have data to predict trends for this year's unique match. Given that financial and logistical burdens imposed by traditional interviews are largely mitigated by virtual interviews, applicants have little extrinsic motive to limit the number of interviews accepted. Matched applicants generally have a higher number of contiguous dermatology ranks, which applicants can only achieve by accepting a greater number of interviews. Applicants have autonomy over this decision and will likely prioritize their own beneficence. Additionally, limiting the number of interviews an applicant can accept would be unjust.

For the beneficence of the department, programs desire the most highly qualified applicants. The delayed Electronic Residency Application Service schedule means less time for holistic review of applications, which could result in a large majority of interview spots going to a small cohort of classically competitive applicants. Without extrinsic motives to decline interviews, this small cohort will likely not fill all available positions, and programs will have to rely on the Supplemental Offer and Acceptance Program.

The responsibility for eluding this problem lies in the applicants' ability to recognize the consequences of applying and interviewing excessively and their subsequent willingness to act justly. From the residency programs' perspective, the high volume of applications hinders their ability to perform a holistic review of applicants. Unfortunately, the subsequent accepting of interviews from programs that applicants do not have a genuine interest in will prevent other qualified and sincerely interested applicants from the opportunity to interview. Therefore, applicants should be counseled that very few applicants with 11 or more contiguous ranks do not match. Ideally, once applicants are educated to this fact, they will voluntarily prioritize nonmaleficence and not take advantage of coordinated interview scheduling. Rather, we hope they will judiciously select the most fitting interviews rather than accommodating the highest number of interviews possible.

Despite robust data on diminishing returns, dermatology applicants continue to apply to more programs on average than any other specialty. Therefore, rather than relying solely on applicants to assume the ethical responsibility, programs should also aim to more broadly distribute interviews by considering the following adjustments:

Perform holistic application reviews, including assessment of fit, research, volunteerism, diversity, and other similar things.

Consider supplemental application questions to afford applicants an opportunity to express their particular interest in a program or geographic location.

Consider increasing the number of candidates interviewed.

These measures will likely contribute to the beneficence of the program overall because they will decrease the likelihood of having unfilled positions and will increase the likelihood of identifying applicants that are the best match for your program.

—Dr Dermatoethicist