Navigating the Virtual Match: Pitfalls of the Virtual Interview.

Each year oral and maxillofacial surgery applicants compete for coveted residency positions. Adopted in 1952, the National Resident Matching Program (match) oversees the process of pairing the preferences of applicants and residency programs. A candidate matches with their top-ranked selection if there is a vacant position. If a favored candidate ranks that program equally, the match replaces the first individual with the preferred applicant. The process continues until positions are filled or residencies exhaust their rank list. The algorithm is renowned for its ability to optimize outcomes for applicants, while ensuring that 99.9% of programs achieve positive results. Today, residency programs are adjusting to the uncertainties and travel restrictions surrounding coronavirus disease 2019 through the incorporation of social media, virtual externships, and virtual interviewing. Adaptations may be necessary during the upcoming virtual match as application inflation may be common in the 2020 to 2021 oral-maxillofacial surgery application cycle. As a result, an added emphasis on the holistic assessment of candidates, strategic extension of interview invitations, and meticulous ranking of applicants and programs may be essential for a successful match.

In a survey distributed to oral-maxillofacial surgery residents in 2019, respondents applied to between 11 and 20 programs. On average, applicants were invited to 11 interviews, of which they attended 9 interviews. In past cycles, finances and availability limited the number of submitted applications and accepted interviews. Highly qualified applicants began to reject additional invitations once they received interviews from their desired programs. These invitations may have been extended to other candidates who were potentially better aligned with some residencies.

Programs may observe an inflated number of submitted applications this cycle as virtual interviewing eliminates financial restraints. In addition, scheduling feasibility of the virtual platform gives highly qualified candidates the ability to accept more interview invitations. Because of the uncertainty surrounding this cycle, applicants may feel inclined to accept more invitations to minimize the odds of completing the cycle unmatched. Such inflation may result in a smaller number of applicants receiving more interview invitations, whereas others with less competitive applications may receive less interviews. As a result, programs may be sacrificing interviews on candidates that have no intention of ranking them highly. This series of events induced by virtual interviewing is potentially double edged: programs may experience unmatched positions because of the disproportionate interviewing of a smaller group of more competitive applicants. Likewise, a higher proportion of candidates with less interview invitations may go unmatched. Such high numbers of open positions and available applicants during the postmatch scramble would certainly increase the mayhem and uncertainty of this period for both parties, potentially resulting in snap decisions and poor pairings.

Opportunities to develop relationships with prospective residents were restricted because of cancelled externships. Virtual interviews may also limit genuine communication. As such, program directors may feel inclined to place additional emphasis on quantifiable markers, such as dental school rank and Comprehensive Basic Science Examination scores. However, basing the distribution of interview invitations on these markers may only exacerbate the potential pitfalls associated with this match.

It may be critical for programs that are not historically preferred by the most competitive applicants to avoid emphasizing quantifiable markers. These programs should interview the caliber of applicant who may be inclined to rank the program highly, thereby maximizing the probability of a match. It may be important to communicate with mutual colleagues to identify a candidate's interest and compatibility. In addition, if virtual interviewing exists for future cycles, transparency regarding the number of accepted interview invitations per candidate may be an effective adaptation. Program directors could use this metric to gauge the probability of matching and may select candidates accordingly. Oral-maxillofacial surgery programs should transition away from a data-driven mindset of candidate selection, similar to the modifications encouraged by our medical school colleagues. Incorporation of a holistic assessment of applicants will shift the focus away from test scores and place emphasis on a candidate's life achievements and fundamental values such as integrity, leadership, work ethic, and collegiality.

The uncertainty surrounding the upcoming application cycle may prompt more programs to participate in postinterview conversations with preferred candidates. Although tempting, such actions may complicate this match further. Postinterview communication may lead applicants to rearrange their rank lists. This may hinder the ability of an applicant to match to their true top choice program. Likewise, applicants may feel inclined to dishonestly express interest in a program in hopes of a successful match. Candidates should resist this external influence and devise rank lists based on their own preferences. This application cycle should remind programs of the need to limit postinterview communication to preserve the integrity of the match.

One proposed solution to these issues of interviewee supply-and-demand and clandestine communications is the use of virtual tokens to signal programs that they are among the most desired interviews to obtain by an applicant. This preference signaling is intended to demystify an applicant's intentions and add value to their application, as potential interviewees have only a limited number of tokens to hand out. Our otolaryngology colleagues will be testing such as system this cycle, and it would behoove us to observe how it plays out. It may be that this attempt to abolish some of the upcoming guesswork only adds another layer of complexity to the game.

With the application cycle underway, widespread modifications to the match may not be possible. Although many variables are out of the control of applicants, candidates can still successfully navigate this year's application cycle. Applicants should accept interviews and devise rank lists following a true-preference strategy, while ensuring honesty in their communications with programs. However, it is critical for program directors to be conscious of application and interview inflation during the virtual match. Programs should holistically assess and rank their applicants, while also being aware of the tribulations of using quantifiable markers as the primary selection criteria. This nontraditional oral-maxillofacial surgery application cycle may finalize the transition to a holistic application review. Although the match was devised to provide the best outcome for both applicant and program, the impact of virtual interviewing will be a true test of the algorithm's ability to successfully match the next class of oral-maxillofacial surgery residents.