I Finally Hit 'Submit' on ERAS—Now What? Virtual Interviewing Advice from AACOM’s Council on Residency Placement

As virtual residency interview season begins, the American Association of Colleges of Osteopathic Medicine (AACOM) spoke with four AACOM Council on Residency Placement (CORP) members about their advice and recommendations to give students a better understanding of what to expect from virtual interviews and how best to navigate the process.

Lisa Cardello is the director for the center for teaching and learning at the Rowan University School of Osteopathic Medicine in Stratford, New Jersey.

Lisa Shelburne is the director of career services at the Lincoln Memorial University - DeBusk College of Osteopathic Medicine in Harrogate, Tennessee.

Holly Waters, DO, is clinical faculty in the department of osteopathic principles and practice at the Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine in Clearwater, Florida, where she teaches on-campus and precepts students in clinic.

Jaishree Patel, PharmD, is the director of career development at the Alabama College of Osteopathic Medicine in Dothan, Alabama.

CORP provides support and career development resources for colleges of osteopathic medicine to successfully mentor students through the transition to graduate medical education.

The answers below have been edited for brevity and clarity.

Q: What do I do after receiving an interview invite?

Ms. Cardello: Respond promptly, because interviews tend to go out in waves, and programs are looking to fill their spots quickly. Keep an eye on your email and spam folder, making sure that you’re responding to invites as soon as possible because programs are just as eager to fill their spots as you are to interview. Also, practice! There are great resources out there, specifically the video interviewing series on the AACOM website, that students can use to prepare. Practice is so important for overall preparation and enhancing your confidence for the upcoming interview season.

Mrs. Shelburne: Once you receive that interview invite, whether by email or phone, be ready. Be ready to interview early, be ready to interview late, be ready to accept what they offer. If you have a scheduling conflict, be ready to be flexible with it, and don’t feel like programs have to work around your schedule because there are probably 800 other students looking to fill that same spot. If something happens, be ready to contact the program to let them know. If you have a scheduling conflict, if an emergency comes up or if there is a power outage in your building and you have to adjust, have a contact ready, and practice, practice, practice.

Dr. Waters: Think strategically about your top choice programs. If there is one you absolutely want to be considered highly for, and they give you a range of dates, time out when you want to interview so that you are going early or late in the interview season. That way, you don’t get lost in the middle-of-the-pack mentality where you might get lost in the shuffle.

Dr. Patel: Be happy and congratulate yourself on getting the interview! That’s the first step in being competitive for a program. Stop comparing yourself to your classmates who’ve gotten interviews in different specialties. And like others have said, do plenty of practice interviews, research the program and know its ins and outs as much as you can before your interview.

Q: When should I expect interview offers?

Ms. Cardello: This is a tricky question because there are so many factors that go into this. There is a lot of variation by specialty. There are general trends where some specialties send invites earlier, some later, and there is also variation based on program size. Larger programs have more spots to fill and will schedule more interviews over a longer amount of time, so they could send out invites earlier. Some specialties this year have agreed on a uniform interview release date, which is also a factor. Don’t compare yourself to your peers, like Dr. Patel mentioned, because there is so much variation. By early November, most invites will likely have been sent, so that could be a good gauge in terms of your overall numbers and risk assessment.

Dr. Waters: In my personal experience and in the experience of my students, there is a wide range for when you can expect interview offers. For the fourth-year student who’s currently rotating with me, he submitted his Electronic Residency Application Service (ERAS) application and within 48 hours he already had multiple interview offers. We’re all thrilled for him and he’s expecting to receive more as time goes on. When I was interviewing for residency, there was one program where I was put either on the wait list or the second round because I didn’t get an offer for that program until about early- to mid-November, almost late November, and it was for a single interview date that was a week away, so I had to rearrange my schedule to be able to attend that interview. Nevertheless, I was glad that I was able to because it was a great opportunity to get to know a program that I might not have otherwise been able to consider. Understand that every program is operating on a different schedule. Later in the season, as students start to cancel interviews if they have already completed as many as they feel like they need, there might be more rounds of interview offers going out in November, December and maybe even January.

Mrs. Shelburne: What I tell our students is that it comes in waves. Don’t ever count yourself out because you don’t know when it will happen. Don’t say, “It’s November, I won’t get any more invites,” because you probably will. November is also the time to start looking at networking with programs to see if you can fill a slot that somebody’s cancelled. Program coordinators need to fill those slots, so let them know you’re flexible. Let them know that at a minute’s notice you’d be happy to interview.

Dr. Patel: One of the mistakes students make is they get obsessed with Reddit. They see people post in their specialty that they got an invite, but they don’t know their circumstances. Those students may have done an audition with them. That program may be working their way through cutoff scores. Maybe they are starting at the beginning of the alphabet and your last name begins with a Z. Don’t be worried about those invites, they will come through the month of October and early November. Remember, it’s a marathon. Don’t get overwhelmed in the beginning, and we are just beginning with interview invites right now.

Q: How quickly do I need to respond to interview invites?

Dr. Patel: You should respond as soon as you can. If you’re on rounds and talking with a patient, don’t pull out your phone and respond then. Wait until you step out of the room and have a minute to check your phone. You want to respond in a timely manner, but don’t let it interfere with your rotation and what you are doing that month.

Dr. Waters: I recommend you respond as soon as possible, if possible, but always within 24 hours to give you a better chance of getting your preferred interview dates. Some programs are notorious for filling up within minutes, if not hours, of offers going out, but a lot of programs will send out offers based on the number of spots they have available, so there should be some flexibility to schedule around what you can manage.

Q: What do I do if I don't get any interview offers? When should I start worrying?

Ms. Cardello: Utilize the expertise and experience of the advisors at your school. They can help guide you through this process and let you know when it’s time to start worrying or not, and help you assess your overall competitiveness. Trust your advisors and seek their guidance when you’re unsure.

Dr. Patel: I agree, reach out to your advisors because they can give you the best advice. If you know someone at the program, maybe alumni from your institution, you can reach out to them too because they will know inside information, but other than that, your advisor should be able to help guide you.

Dr. Waters: If it’s been longer than you expect and you haven’t received any interview offers, it’s worthwhile to check ERAS to make sure your application was submitted correctly, that you’re not missing any important required documents and that you sent your applications to the right places. If you’re applying to programs within your anticipated match ability based on your stats and scores, within a week or two you would expect to be getting interviews. If it’s been longer than that, it’s always good to check to make sure you didn’t forget anything important.

Q: What do I do when I am on rotation and need to be professional but also need to pay attention to my phone?

Dr. Waters: As a clinical preceptor, I advise students that it is never appropriate to pull your phone out in front of your patient unless it’s directly related to that patient’s care, for example, if your preceptor asks you to look something up, or you tell a patient that you have a referral and are sharing the link with them online. Otherwise, the patient comes first. That is their time, their appointment and their medical care. As important as residency interviews are for your career, the patient in front of you trumps that. There is usually plenty of time in between patients to check your phone for interview offers, such as when your attending is writing notes, or in between patient rooms on rounds. Attendings, especially during interview season, are pretty accommodating with that. If you’re rotating with someone a little older who isn’t as aware of the ERAS cycle, it never hurts to give them a heads up to let them know you just submitted residency applications, and you’re sorry if you pull out your phone but you don’t want to miss an interview offer. Nineteen times out of 20, your attending will be 100 percent understanding of that fact. If you need to ask to take 15-20 minutes to step away to schedule a highly desired interview, that’s totally appropriate as well, just make sure you are balancing taking time to schedule interviews and continuing to fulfill your duties as a medical student on rotation. It would be terrible for you to get dinged on professionalism because you put scheduling interview offers over patient care. Now, if you’re on a surgery rotation, maybe don’t sit in on a six-hour-plus surgery when you can’t break the sterile field if you’re expecting or hoping for an interview offer from your top choice program and want to be able to respond right away, because I can tell you the scrub nurse won’t be interested in helping you rescrub just so you can check your phone.

Mrs. Shelburne: When students ask, “If I have only a five-minute window to respond to an interview offer, what do I do if I’m interviewing a patient and hear my phone go off?” I say, “Well, you finish interviewing that patient because you’re in medicine. That’s what you do.” If you have a program that offers you five minutes to respond, and they know that you’re on clinical rotations as a fourth-year medical student, and that program expects you to get up and leave the patient’s bedside, is that the program where you want to train, where you want to spend the next three to four years?

Q: How many interviews is too many?

Dr. Patel: If you look at the NRMP Match data, you need about 10-12 interviews to match in most specialties. Ten to 12 is a good number to start with. Remember that virtual interviewing can be a bit tricky for some students, so if you’re not comfortable, you can schedule your first couple of interviews with programs that aren’t as desirable to you, to let you get up to par with virtual interviewing. In that case, you might need 15 interviews, but there is a point of no return. If you’re not spending the time getting to know the program, looking it up, knowing its strengths, coming up with appropriate questions, it’s going to be a generic interview for you and for the program and won’t be memorable for either of you. If you’re not going to invest the time, then it’s not worth doing the interview.

Dr. Waters: When it comes to the number of interviews, you want to aim for a number where you have a high chance of matching, but not too many that you’re just going through the motions. When I did my residency interviews, it was at about the 10-12 range when my brain started losing a lot of details. Even though I was physically traveling to those programs, I had a hard time keeping them straight. So, make sure you’re taking good notes because in the virtual environment, you’ll have even fewer opportunities for making sure you keep these programs individualized to know which ones you want to rank. More than 20 interviews are likely more than most people can keep straight unless you have a particular reason for doing so many, like a couple’s match or you’re interested in a highly competitive specialty. More than 30 would probably result in completely diminished returns on your time invested and the time away from your rotations.

Q: How do I succeed at a virtual interview?

Mrs. Shelburne: Succeeding at virtual interviews begins with practicing. You can’t practice enough. You need to be comfortable. You also need to utilize the resources your school provides, and I recommend reviewing AACOM’s interview resources. Remember to convey to your interviewers if you want to take notes, or are reading notes, so they know what you’re doing when you look off-screen. Everything you need to remember in an in-person interview is doubly important in a virtual interview. Being on time, having good Internet, having back up Internet just in case, is all important. Practice for every possible scenario. If you need to go elsewhere for an interview in the event of a hurricane that knocks out your power, practice that scenario!

Dr. Waters: For virtual interviewing, the number one important thing for you as a candidate and someone trying to rank is to make sure you both get a good impression of the program and leave a good impression for the program. Do your research ahead of time. Know what the program’s strengths are. Know what questions you want to ask and write them down before the interview, so you have them ready. Know your application inside and out because your interviewers will be pulling details from your CV, personal statement and from your entire academic history. Be prepared to answer questions about anything you put on your application. Also, know how to highlight yourself as a unique individual so you can stand out, especially in the virtual realm.

Dr. Patel: What students miss between a virtual and in-person interview is eye contact. Even if you have to put a sticky note by your camera that says, LOOK HERE, you want to look at the camera and not at the person’s video screen to imitate eye contact. Another pit fall is not remembering things. You can always have your notes open in a document, so it looks like you’re looking at your interviewers, but you’re really looking at your notes on your computer screen.

Dr. Waters: Make sure your phone is away and off or on silent. It’s very obvious on Zoom when you’re looking down at your phone that’s a little bit off screen versus paying attention to what’s going on versus looking at your notes. Don’t even be tempted to pull out your phone.

Mrs. Shelburne: If you have risk factors in your application, if you’ve been on a leave of absence, if you failed a class, if you failed one of your COMLEX or USMLE exams, be sure that’s not the center of your application. One thing I’ve seen with the virtual environment is the increased tendency to overshare. If you have a leave of absence for a medical reason, have your comments about this practiced and written out. Be ready to explain what happened, how it affected you, how you fixed it and how it could affect you as a resident. This is a job interview, so be careful. Your interviewers want to know that you’re coming to their program and can do a good job. Don’t overshare.

Q: How do you get to know a program if you have not been in that city?

Dr. Waters: When I was interviewing in-person for programs in cities I’d never been to before, I first looked at any personal connections I had in the area—friends, family or friends of family—to learn what it was like living there and what kinds of hobbies they engaged in. A huge key to success in any residency program, no matter where you go or what specialty you’re in, is your personal support system. While you may be able to find that in your residency program, it’s great to find support outside it, as well. I also recommend talking to current residents about what they like to do in their free time, how they enjoy their city or local area and what things there are to do. Those are the best ways to get to know what life will be like somewhere you’ve never lived before.

Mrs. Shelburne: Network with people you may have connections to in the program and find out what they like about the area. Residents love to talk about their programs and should be open to sharing information with you. Make sure to attend any and all virtual offerings, meet and greets and information sessions the program hosts. Also, work with graduates from your school. They went to medical school where you did, and chances are they were interested in their program for the same reasons as you. Information you find on Reddit about toxic programs or cities may not always be accurate, so talk to those you know who graduated from your school and interviewed or are currently training at programs you’re interested in ranking.

Q: What final advice would you share with students?

Dr. Patel: Good luck! We know this is a stressful process, so reach out to your school to lessen the anxiety you feel. Everyone is going through the same thing. Remember, you’re not the only one.

Mrs. Shelburne: We can’t wait to see the places you go! This is an exciting time, good luck!

Dr. Waters: Remember, this is about finding a program that will be excited to train you—somewhere you can thrive and learn to be the best doctor you can be. Use the interviewing process to identify a good fit where you’ll want to spend the next few years.

For more help successfully navigating virtual interviewing, view AACOM’s Virtual Interview Video Series.