Applying to Residency in the COVID-19 Era: Virtual Interview Tips for Success.

The COVID-19 pandemic has dramatically impacted medical education, with particular disruption to traditional residency recruiting processes. On May 11, 2020, the Coalition for Physician Accountability (a coalition of national medical organizations) released its recommendations for the 2020–2021 application cycle, one of which stated, “all programs commit to online interviews and virtual visits for all applicants rather than in-person interviews for the entire cycle.”[1] Consequently, programs and medical students have had to rapidly adapt to this dynamic landscape and engage in newly created virtual opportunities.

Before COVID-19, the use of virtual interviews for recruitment was limited to a few fellowship and residency programs. In regard to residency, virtual interviews were utilized during recruitment for surgical and nonsurgical specialties, including plastic surgery, urology, ophthalmology, OB-GYN, internal medicine, emergency medicine, family medicine, and anesthesiology.[2-4] Although most of these studies have described successful adoption of virtual interviews for recruitment, barriers (including applicant discomfort with the virtual format and dissatisfaction with how the applicant presented themselves during the video interview) were also reported.

The OB-GYN residency program at Mayo Clinic implemented a 3-question asynchronous video interview to screen applicants during the 2018 and 2019 seasons.[2] Although 58% of candidates viewed the asynchronous video interview as effective, a large percentage (45%) were uncomfortable with it.[2] Shah et al described their experience comparing Skype video interviews and in-person interviews during the 2011 urology match.[3] Although the overall satisfaction was high with both interview modalities, the web-based interview was perceived as less effective in allowing applicants to represent themselves well during the interview.[3] Similarly, 15% of candidates applying for orthopedic surgery fellowship at one institution did not believe they presented themselves satisfactorily for video interviews.[4] These findings, along with anecdotal experience speaking with current applicants, expose a gap in an applicant’s comfort with the virtual interview process and presents opportunities for continued development in this area. Based our institution’s experience, we recommend strategies for success during virtual interviews in Tables 1 and 2.

Table 1.

Recommendations for Applicants before and after the Virtual Interview

Before the Interview
Environment	Identify a suitable location for the interview. Choose a location that is well-lit and noise- and distraction-free. A neutral colored, plain background is preferable over a virtual background. We advise sitting in front of a window to optimize your light source and avoid any windows in the background.
Technology	Ensure a reliable internet connection. Assess your internet speed using websites such as www.fast.com. Speed can be improved by closing other running programs and disconnecting Wi-Fi from other devices.
	Familiarize yourself with the program’s chosen technology platform early. Have a backup plan in case the video platform does not work. This may include switching to a phone interview.
Equipment	Ensure your audio is loud and clear. Using your computer’s built-in audio will usually suffice, however, consider using a small external lapel microphone as an alternative. Small headphones such as AirPods are also acceptable. Consider investing in a ring light, which can be purchased on Amazon.
Content preparation	Know yourself and anything listed on your application. Reflect on each of your experiences and write down 2–4 bullet points you may want to convey about each during the interview. Look at the program’s website and social media to understand what interview format will be used. Research the program and prepare thoughtful questions.
Practice	Practice responding to common interview questions with friends or family using the virtual platform before your interview. We highly recommend recording and watching a mock interview to critique and improve your on-camera appearance.
After the Interview
Reflect	Shortly after your interview, reflect and write down your impressions of the program.
Follow-up	Depending on the specialty, it may be appropriate to send a thank you note to your interviewers. However, certain specialties explicitly prohibit this; so be sure to find out beforehand.
Improve	Assess your performance. Understand what you think went well and what may be improved upon. Continue to practice and work on any areas of weakness.

Table 2.

Recommendations for Applicants during the Virtual Interview

During the Interview
Appearance	Dress professionally as you would with an in-person interview. Wear colors that contrast against your background. It is advisable that your camera is eye level and captures your entire face. Check your on-screen appearance using FaceTime or a similar program immediately before the virtual interview. Although it may feel unnatural initially, it is important to look directly at the camera and maintain eye contact. Try to remain conscious of your body language.
Interview content	Interviewers may ask general questions about yourself, behavioral questions to assess your knowledge and experiences, or situational questions to understand how you may respond in various hypothetical scenarios. Commonly asked questions include:
	• Tell me about yourself.
	• Why this specialty?
	• Why this program?
	• Describe your research experience.
	• Tell me about your strengths and weaknesses.
	• Tell me about a time you failed.
	• Where do you see yourself in 5 or 10 years?
Responding to interview questions	For certain behavioral or situational questions, using a consistent and structured approach when responding may be valuable. The STAR method is one such example—situation (describe the situation or task), task (what goal were you working toward?), action (describe any actions you took), and result (describe the outcome of the situation). Avoid reading responses or sounding rehearsed.
Other tips	Be honest, concise, and confident. Although you should practice responding to common interview questions, it is essential to sound natural and conversational. Try to limit responses to no more than 1.5 to 2 minutes.
	Keep water and snacks nearby but refrain from eating or drinking until breaks.
	If you lose internet connection or something does not go according to plan, do not panic and remain flexible.
	Remember to smile when appropriate and have fun.

The importance of effective communication and strong interpersonal skills during an interview cannot be overstated. In the 2018 NRMP Program Director’s Survey, 95% and 96% of programs reported interpersonal skills and interactions with faculty during the interview, respectively, as the most important factors in ranking applicants.[5] Without traditional in-person interviews, students may have to work harder to demonstrate these qualities virtually. We recommend programs use synchronous interviews, as it allows applicants to respond in real-time and better display these qualities.

Virtual interviews have some limitations for applicants, including an inability to experience the program first-hand and difficulty evaluating the program. Similarly, programs also face challenges assessing candidates virtually. However, virtual interviews confer distinct advantages, including cost savings, flexibility of scheduling, and convenience, which may lead to their permanence in the recruitment process. Although the degree to which video interviews and virtual opportunities are incorporated into the residency recruitment process remains to be seen, applicants must be well-prepared and equipped with the skills to excel under the virtual video format.