Bethesda, MD, May 13, 2022 (GLOBE NEWSWIRE) — The American Association of Colleges of Osteopathic Medicine (AACOM) strongly recommends that residency programs give students, from all backgrounds and medical schools, the opportunity to interview in person or virtually during the 2022-23 Candidacy Cycle. The only way to ensure that all medical students have a fair and equal chance at matching is to let the students decide how best to present themselves during their interview for the positions they will hold during the three to the next seven years. This choice is especially important for minority communities in medicine, which include the 25% of all medical students with a degree in osteopathic medicine (DO) as well as underrepresented medical students (UIM) with a medical degree DO or MD. Speaking of this timely need, Dr. Robert A. Cain, President and CEO of AACOM, issued the following statement:
Bias in residency decisions
“Implicit or explicit bias against certain types of medical students is an unfortunate, but very real, challenge in medicine. In just a few weeks, students will begin the residency application process and as we move into this next residency matching cycle, we have an obligation to mitigate these biases wherever we can. Allowing students to interview in person can help them be more competitive and alleviate some of the disadvantages that plague minority communities when seeking a residency position. There are two things all medical students ask for when participating in this process – the first is accurate, timely, and transparent information about the process itself; the second is a fair playing field where everyone has the opportunity to compete fairly. In the spirit of achieving both of these goals, AACOM today calls on all residency programs to offer both in-person and virtual interviews and allow students to choose the option that best suits their needs.
Like a February 2021 article in the Journal of the National Medical Association warned,“The move to virtual interviews may have a disproportionate detrimental effect on UIM students…” and that “This move to virtual interviews has the potential to aggravate existing issues with implicit bias and introduce new aspects of this bias into the process residency application.
There is no doubt that in the previous two years, security concerns due to the COVID pandemic have rightly taken precedence. AACOM supported recommendations that all interviews should be posted online during this time, with the caveat that further research and studies should be done before any future recommendations are made to limit or eliminate interviews. in person. Entering this next cycle in June 2022, fortunately, we are in a different place, with widespread access to vaccination and boosters; students learning in person; and the removal of travel restrictions. Based on evidence, students are now allowed to travel to visit locations and speak with program directors. We also have survey data and direct feedback from students that eliminating the option of in-person interviews deepens discrimination against DOs and other minority students. Conversely, to date, no formal studies have been conducted to ensure that the bias of virtual interviews is fully understood and no evidence has provided guidance on how to mitigate this harm.
Why virtual interviews put DOs and other candidates at a disadvantage
One of the unique aspects of DO’s professional history is that the care and training we provide often occurs in more rural areas of the country where it is most needed and otherwise would not exist. Yet this commitment to community training means that DO students do not have basic residency rotations at the larger, more urban academic medical centers where most residency positions are located. The same is true for many international medical graduates and some American medical students educated in more rural settings. The vast majority of American medical students are trained in large medical centers; therefore, they are more exposed to residency programs during their clinical training and have a greater opportunity to interact with program directors who make decisions about suitable applicants. Virtual interviews for medical students pose less risk to the overall strength of their application, while weakening that of DOs and others.
We need to listen to students
Fundamentally, at a time when the medical community is striving to foster diversity and create more inclusive environments, we should seize every opportunity to eliminate discriminatory practices. Underrepresented and minority communities expressed a preference for in-person interview experiences to be able to more fully assess the suitability of a potential residency environment. We cannot forget that students envision entering into a comprehensive, multi-year relationship with the residency program they choose.
Failing to give students the opportunity to fully explore the environment and community in which they engage risks increasing drop-out rates and aggravating ever-increasing burnout in the profession. The Simple Option is what today’s medical students are asking for, allowing them to consider the cost of travel in the context of their overall student debt. A 2021 survey of all match students by the National Residency Matching Program showed that 51.4% of all students preferred in-person interviews and only 20.7% declared a preference for virtual. AACOM’s survey of osteopathic medical students found that a majority of more than 1,000 respondents believed that if a program only offered virtual interviews, they would be at a disadvantage compared to other students.
We need to listen to program directors and deans
Program directors in rural and/or underserved communities have a harder time attracting students who are unfamiliar with those localities. Face-to-face interviews allow them to better gauge the real desire of students to learn and serve there. A 2021 National Residency Match Program (NRMP) survey reported that 66% of program directors found virtual interviews to be an inconvenience in assessing applicants’ interest in programs and 67% considered them an inconvenience in assessing Candidates’ interpersonal skills and alignment with the program. We must not ignore the contribution of those most affected by this problem.
In an AACOM survey, 100% of osteopathic medical college deans who responded support the position that programs should offer virtual and in-person interviews. Deans and professors of osteopathic medical schools know that many residency programs, especially in competitive specialties, will not consider applicants they have not seen in their clinical environment. And while visiting programs are not free, the cost of travel is minimal and can be reduced as students select fewer programs for in-person interviews and complete others virtually. There is no doubt that conducting in-person interviews also comes at a cost to programs, but the long-term benefits far outweigh this position in an overall budget. Students should be able to connect in person if they so choose and programs should provide this opportunity.
A call to action for residency programs
AACOM is committed to ensuring that DO students and all minority communities within medicine have an equal opportunity to find a residency program that best suits their needs while continuing to become a physician. We therefore strongly recommend that all residency programs offer both in-person and virtual interviews for the 2022-23 application cycle. We must eliminate discriminatory practices in medicine wherever possible and break down the barriers that prevent diverse, talented, and committed students from becoming physicians. Giving students choice in how they compete for residencies is a seemingly small, but in practice, very important step in that direction.
the American Association of Colleges of Osteopathic Medicine (AACOM) leads and advocates the full continuum of osteopathic medical education to improve the health of the public. Founded in 1898 to support and assist the nation’s schools of osteopathic medicine, AACOM represents all 38 osteopathic medical schools – training nearly 34,000 future physicians, 25% of all U.S. medical students – at 60 teaching locations in 34 U.S. states, as well as graduate osteopathic medical education professionals and interns in U.S. medical centers, hospitals, clinics, and health systems.
Joseph Shapiro American Association of Colleges of Osteopathic Medicine 240-938-0746 [email protected]