Sarah Householder spent her final year of college traveling the United States: from the Connecticut campus to New York (three times), Illinois (twice), Minnesota, Maryland, Wisconsin, Georgia and, every time, back. At the time, Householder was leading her college’s first all-female a cappella group with her jazzy soprano voice. But she wasn’t spinning – and she barely had time for harmony. The impetus behind his jet-set lifestyle? Enter medical school.
Householder, now in third year at Columbia University’s Vagelos College of Physicians and Surgeons, applied to 21 schools – just four above average – between August 2017 and February 2018. She was fortunate enough to be interviewed at age 11, usually by plane on short notice. . She continued to pack her suitcase over and over again in the hope of getting in and, more importantly, getting good financial help. “What I remember most is the time, just how long it took,” says Householder. The “interview” is not so much a conversation as a ritual lasting several days, consisting of trips, panels, meals, visits – all during which future students are observed by the admissions committee – in addition to the real formal answer to the questions. Second, all of that travel takes a lot of money: Householder has tracked almost every penny spent on apps on a spreadsheet. Between August and October alone, she spent $ 905 on interviews, “Spirit: Traveling – Chicago: $ 292”, “Ann Taylor; Blazer – Interviews, $ 55.30, ”“ Uber, Trip to Michigan, $ 34.92 ”- the list goes on.
Why apply – then pay to visit – so many schools? Acceptance rates for medical schools are low; only 41% of candidates enter all over. As several candidates I’ve spoken to explained, most candidates are rarely, if ever, able to turn down an interview offer. It was especially true this year: with a record ascend in applications from this last cycle, interview offers have been more valuable than ever. But they also took less time, cheaper to attend, and therefore a little a little fairer and easier for the hopeful doctors who can’t shell out (and maybe skip hours of work too) to try to impress the committees. We can even hope that a small piece of the medical school industrial complex has been overthrown for good.
All because this year’s interviews, like so many things, have gone virtual. A typical remote interview experience looked like this: a welcome Zoom call in the morning, a question-and-answer session with students and / or faculty, a financial aid panel, a tour video, and two interviews ( 20 to 40 minutes each) with the teachers. It could all be done in a dorm, in a presentable top and sweatshirts, and it was over in a matter of hours.
Overall it worked. “I was really concerned that [our interview day] would be difficult to translate into a virtual platform, ”says Mark Yeckel, associate dean of admissions at the Frank H. Netter MD School of Medicine at Quinnipiac University. “It went better than I could ever have imagined.” In fact, every admissions officer I asked said they were left with something that looked like they were pleasantly surprised. “Assuming everyone has the equipment they need, [the remote process] is very effective for applicants and the admissions committee, ”says Demicha Rankin, anesthesiologist and associate dean of admissions at Ohio State University College of Medicine. Rankin noted that the reduction in the financial burden on students was significant.
I didn’t have to look far to find candidates who were pro-virtual interview. I asked how the process went in a forum on studentdoctor.net, one of the clearinghouses for pre-meds for sharing information. the responses were overwhelmingly positive. Virtual Interviews Save Money: “I earn about $ 16 / hour working full-time in clinical research at a large academic medical center,” user BeingForItself wrote. “Because the interviews were virtual, not having to worry about paying for flights, hotel stays, or paying for food while traveling helped a lot.” Virtual interviews save time – potentially, a lot of it: “I live in rural America, 7 hours from the nearest major airport,” added a user identifying himself as back2skewl. “The virtual interviews were quite frankly the only reason I had such a successful cycle.” One user identifying himself as anotgramnegative was able to continue working as an “intensive care nurse who has worked extensively with critically ill COVID + patients” without interruption throughout the application cycle. The virtual aspect “allowed me to take a job traveling across the country and doing interviews,” they wrote. (Virtual interviews even save lives!) On the negative side, one user argued that reducing interview friction makes it easier for the most desirable candidates to store interview spots, as they can accept any offer. interviews given to them; but it has long been a concern that candidates who can afford all the tickets do so anyway.
This makes some feel that interviews traditionally required travel. Before webcams, if you wanted to talk to someone and see them too – and show them your campus – you had to meet in person. It is no longer the case, and it has not been for most of this millennium. So why did the in-person interviews persist? Part of the answer is that things never are had to change, and therefore has not changed. But it’s also that the interview days are not only devoted to the interview, or even to giving professors the opportunity to chat with the candidates casually. Interview visit extravagances give schools the opportunity to recruit the candidates they want most. Several admissions officers I spoke with expressed concern that remote interviews could put less prestigious, newer, or more rural medical schools at a disadvantage that use them to woo high-profile applicants. “Honestly, it hurts a school like us,” says Yeckel of Quinnipiac. “We’re a new school, we’re a young school, but we have a very, very good teaching and learning facility. So when [applicants] don’t see it, it can make it hard to recruit people. But even prestigious schools also like to court. Johns Hopkins School of Medicine, Paul White, associate dean of admissions told me, cherishes the opportunity to dispel “myths” about Baltimore.
This is not a sufficient reason, in my opinion. Interviews in future application cycles should be kept at bay. If schools really want the opportunity to attract students to their playground, they can invite successful applicants to visit after they accept them, as many are already doing with the days of “Second Look”. Ultimately, tons people want to become doctors, and a nascent pool of candidates competing for a lagging number of seats means that more and more candidates who would make perfect doctors will not be accepted anywhere. This fuels an admissions arms race where applicants do (and for those who can, pay) just about anything to get in, and too often the ability to pay is mistaken for enthusiasm – or worse, aptitude. “There is now a vast infrastructure to extract money from medical trainees, schools for licensing exams, licensing authorities, board certifications,” Bryan Carmody, nephrologist, assistant professor at Eastern Virginia Medical School, and prolific medical blogger, told me. “And it exists because it is possible.” Perhaps not surprisingly, 51% of medical students come from the richest quintile of households, including 24% from the richest 5%. While the interview process is not the biggest of the many problems in American education that cause most physicians to come from wealthy backgrounds, it is a cog that deserves to be removed. Keeping the interview at bay would help dismantle a small – but significant – part of the larger infrastructure that prevents American physicians from reflecting the population they serve.
And there is hope that he will stay away. On March 23, an admissions officer questioned the AAMC group’s private student affairs mailing list regarding plans for the next admissions cycle. The results, shared with me by a listserv member, are promising. Of 64 officers who responded on behalf of their school, one will conduct in-person interviews. Two are undecided. Three will be hybrids, which is good, but not perfect. (As Yeckel and others told me, students will likely understand that showing up in person will give them an advantage, even if schools promise it won’t). Encouragingly, four are likely far away and 54 are far away – meaning applicants will have so much less flights to plan and days of their lives to miss. But that upcoming cycle is still being planned with the pandemic in mind. It is the one according to which will be the real test.