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Ch. 9 - Interview Season Logistics

The interview season can be both an exciting and memorable part of your journey through medical school. While the logistics of planning your interview trail can seem daunting at first, understanding some trends in the match data and preparing in advance can ensure you make the most of it. There are some specifics about the interview process you should understand.

How important are residency interviews?

Residency interviews play a crucial role in your match success. Each interview is a way for the program director, faculty, and residents to get to know you personally. Your performance on interview day is a significant factor in determining your placement on the program’s rank list. 

In the 2018 NRMP Program Director Survey, 98% of programs considered interpersonal skills an important factor in ranking applicants, and 94% considered interactions with faculty and residents on interview day a key component.1 Together, these were considered to be more important elements in ranking applicants than USMLE/COMLEX scores, class ranking, volunteer/extracurricular activities, personal statements, or post-interview communications, just to name a few.1

How many interviews should I go on?

There is no universal answer to how many interviews will guarantee a match, but NRMP data can guide you. Your match depends on how you rank your  programs and how the programs rank you. A match can only occur if both parties are ranked by one another, and programs will only rank you if they’ve interviewed you.

The probability of matching is related to the number of contiguous ranks.For allopathic and osteopathic senior medical students, the probability of matching is 80% at around 6–7 contiguous ranks and becomes > 95% at around 11–12.2,3 Therefore, the typical applicant should aim for 11–12 interviews.

Chapter 8: Understanding Your Competitiveness: Apply Smarter, not Harder guided you on assessing your competitiveness. The application recommendations exist to support you in obtaining 11–12 interviews.

FIGURE 9.1. Probability of Matching to Preferred Specialty by Number of Contiguous Ranks2-4

IMG Students: For non-U.S. IMGs, 18 contiguous ranks correlates to < 90% probability of matching.4 Some programs will not interview IMGs at all; this data is available as a filter on EMRA Match.

Latecomers: If you applied particularly late in the season, you may face challenges getting the recommended number of interviews. If this is the case, work closely with your advisors and consider the following:

  1. Don’t intentionally go unmatched and try to scramble. EM historically has had few, if any, unfilled spots. Scrambling into another specialty is also highly risky and should be avoided.7
  2. With your advisor’s help, develop a back-up plan. Depending on your situation, this may mean dual applying to a preliminary/transitional year or another specialty. If you plan to re-apply in EM, make sure you understand GME funding rules to avoid future complications.
  3. Splitting 4th year: Many medical schools have an opportunity to split 4th year. This maintains your eligibility for the match, does not create a gap year in your application, and maintains financial aid and GME funding.
  4. Emergency medicine is a growing specialty, and brand-new programs occasionally fill their first class outside the match. This is uncommon, but worth exploring if the opportunity arises.
  5. Don’t expect to be able to complete a different residency, such as family medicine or internal medicine, with the expectation of practicing emergency medicine afterward. This is advice that many individuals outside of EM will offer as a secondary option. As EM grows, the demand for ABEM board-certified providers also grows. Without completing an EM residency, you will not be board-eligible. This leads to VERY limited job opportunities.
  6. Above all, speak with your advisor and medical school deans about your options. Each program, applicant, and application is different, and expert advice and assistance can make the difference in whether you match.

Juggling the Schedule

Many interview invitations are extended in October after the Dean’s Letter is released; however, additional invitations occur throughout the entire interview season as students cancel and more dates become available. Generally, interviews are conducted in October through January, with the majority (> 60%) occurring in November and December.1 Appropriate scheduling and planning of your academic schedule is a vital part of ensuring that you have the availability to attend your desired interviews.

FIGURE 9.2. Interview Activity1 (n=84)

Couples Match: To save money, consider scheduling interviews together with your partner in the same city. Most programs report trying to coordinate schedules to allow couples to interview at a similar time, although this may be difficult.

Military Match: Students must arrange interviews with programs separately from the MODS application, often via email with the program coordinator early in the year. Some institutions may offer phone or video interviews — try to schedule an in-person interview whenever possible. Consider scheduling civilian interviews late in the season (mid-December to January). This allows adequate time to cancel your interviews if you match in a military program.

During the interview-heavy months, one strategy is to dedicate an entire month to interviews if your school allows it. Another strategy is to purposefully schedule rotations that are less rigorous or do not necessarily have clinical requirements. If you cannot arrange for such a schedule, talk to your advisor about elective options that are more conducive for traveling to interviews.

At-Risk Candidates: If you are a less competitive applicant, early interviews might not be as forthcoming. It may be beneficial to plan to take off January for interviews rather than one of the earlier months.

Latecomers: Depending on when you submitted your application, leaving January available for interviews may be a good plan for you, too.

Keep in mind that programs generally offer an optional interview dinner or social event; this may be held the night before, the night of, or sometimes the night after your interview. While these events might not be expressly mandatory, attendance is strongly recommended whenever possible. These informal gatherings are an important way to meet the residents, learn about the culture of the program, and show your interest.

Exercise caution when scheduling multiple interviews back-to-back. In some instances, this may be helpful or necessary in cutting down on travel costs or time away from clinical duties. Prolonged periods of travel, however, can be exhausting and may adversely affect your performance on interview day. Appearing tired may be misinterpreted as being disinterested and can potentially hurt you in the ranking process.

Communication and Scheduling Etiquette

Interview offers may be extended through a scheduling system (eg, Interview Broker or ERAS Interview Scheduler) or sent directly from the program itself. Applicants typically receive notification of interview offers via email. Sync your email to your mobile device or even create a separate email account specifically for interviews to ensure you don’t miss any offers. It is also a good idea to routinely check your junk or spam folders in case some invitations are accidentally routed there.

Handle interview invitations promptly. Some programs may send out more invitations than available interview spots (this is atypical, yet something to be aware of), so your timely response is critical. When securing a spot, there may also be an option to choose either morning or afternoon. Once scheduled, programs such as Interview Broker will email a confirmation to you of the date/time of the interview. If you find yourself using multiple websites or applications to schedule interviews, it may also be advantageous to dedicate a planner or calendar to keep track of all of your interviews.

Be professional if you need to cancel. Some cancellations are necessary because of travel or financial constraints, and sometimes applicants cancel interviews after they feel they have attended enough. No matter the reason, advance notice is a must. Try to cancel far enough in advance to allow the program time to find another applicant to take your place. Generally, cancellations should not be made less than 2 weeks from the date of the interview, and a month or more beforehand is ideal.

Don’t harm your chances before you even arrive for the interview. Other scheduling behaviors that reflect poorly on you include hoarding, double-booking, and no-shows. In the rush of initial interview offers, it’s tempting to accept every offer — even if you have no real interest in a program. Resist this urge. Remember that everything you do can be evaluated by programs, and unprofessional behavior can dramatically influence programs’ perception of you. Once you have obtained enough interview offers at programs where you have a genuine interest, it is unnecessary to hoard additional interviews. With enough cancellation notice, those spots can be freed up for other students. 

If you double-book, decide which interview you will attend and let the other program know as soon as possible. While double-booking can be tempting, particularly if you are unsure which program you like best, understand that it is highly frowned upon. In fact, scheduling services actively combat them through different policies. ERAS does not allow any double-booking. Interview Broker has a double-booking policy that notifies both programs at 48 hours if you do not resolve the conflict. Thalamus will be adopting a similar policy if double-bookings begin to occur. Retaining a double-booking past 48 hours may lead to programs rescinding your interview offers. After you submit your applications, while awaiting interview offers, create a pre-ranking list of your programs by desirability. When you achieve an excess of interviews or find yourself double-booked, use this list to choose which interviews to give up.

Finally, it is important to actually attend the interviews you schedule. No-showing is unprofessional and can hurt your chances of matching. Word can (and likely will) get back to the dean of your school and the program director of your home institution. Remember this is very much a job interview. Your professionalism is being evaluated at every stage of this process. 

Managing Costs on the Interview Trail

Interviewing is expensive. The costs of travel, lodging, and the increasing number of programs to which applicants apply all add up to a heavy financial burden. In one study, it was estimated that the average interview season expense per student is over $5,000, with 67% going to airfare and lodging.5 Another study estimated that the total cost of pursuing an EM residency, including costs related to away rotations, is over $8,000.6 While some of these costs are unavoidable, there are a few ways to reduce your expenses on the interview trail.

  • Use credit cards with rewards programs — and learn the intricacies of those programs.
  • Bunk with friends (or friends of friends), and check out services like Swap & Snooze, which arranges free lodging for medical students on the interview trail.
  • When possible, stay with residents from the program where you are interviewing. Sometimes this opportunity will be obvious in pre-interview communication with the residency program coordinator; if not, there is no harm in asking.
  • Plan your interviews to maximize your travel dollar; cluster interviews geographically.
  • Consider driving instead of flying.

Unfortunately, the process of applying and interviewing is expensive, but it is an important investment in your career. Anticipating the cost will allow you to budget appropriately, and careful planning can help alleviate additional stress.

Additional Logistical Tips

  • Bring appropriate weather gear (eg, umbrella, long coat, etc.).
  • Always have a backup! Pack a backup dress shirt/blouse, pants, pantyhose, tie, etc. When traveling to interviews, always observe Murphy’s law (what can go wrong, will go wrong). This is also helpful if you have interviews back-to-back and do not have a chance to dry-clean your clothes.
  • Wear comfortable shoes. You may be walking a lot during interviews. 
  • Bring a notepad to jot down questions to ask during your individual interviews.
  • If flying, be wary of checking your bags.

The Bottom Line

  • An applicant of average competitiveness should go on enough interviews to be able to rank 11–12 programs, which gives them a > 95% chance of matching.
  • The majority of interview invitations are sent in October, and the majority of interviews are conducted in November and December.
  • Be considerate of your colleagues and programs during interview season. Hoarding interview invitations at programs you don’t intend to rank takes away interview opportunities from your colleagues, and if you wait too long to cancel, it makes it difficult for the program to book someone else in your place.
  • Prepare to spend approximately $5,000 on the residency application and interview process (not including any expenses related to doing away rotations).
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