Successful Virtual Interviews

The coronavirus disease 2019 (COVID-19) pandemic coincided with the interviewing period of multiple surgical subspecialty fellowships including cardiothoracic surgery, complex general surgical oncology, transplant surgery, plastic surgery, and vascular surgery, among others. Due to recommendations for social distancing and institutional travel bans, fellowship programs have been required to rapidly transition from the traditional, in-person interviews, to web-based, virtual interviews. The interview is a critical phase of trainee selection, and several programs have published their new fellowship interview structures, as virtual interviewing will likely remain the norm for the foreseeable future. This new structure will dramatically impact upcoming fellowship interviews and the medical student residency Match, and programs with virtual interviewing experience are beginning to describe their virtual interviewing methods.1–4 Rather than describe 1 specific program's approach, the purpose of this manuscript is to provide recommendations to both applicants and institutions for virtual interview processes based on the experiences and perspectives of recent surgical fellowship candidates. In total, the authors completed 40 virtual interviews in 3 surgical subspecialties for programs located across multiple geographic regions of the United States and Canada. The suggestions we present are not specialty specific, but are broadly applicable to virtual interviews across a range of trainee levels including medical school, residency, and fellowship. ADVICE TO APPLICANTS In addition to usual preparation advice for interviews, we recommend applicants prepare for virtual interviews in 3 domains: optimizing the physical space, conducting a technology trial run, and cultivating habits for effective virtual interviewing. The purpose of these preparations are 3-fold: (1) help applicants remain physically comfortable throughout the interview to optimize their interview performance, (2) minimize distractions or technological blunders that will detract the interviewer's attention away from the candidate, and (3) allow the candidate to take full advantage of all interview activities, so they can gain the information necessary to optimally inform their career decisions such as making a rank order list. Optimizing the Physical Environment Applicants would ideally set up an interviewing environment that is both physically comfortable and also allows the applicant the strongest possible interview performance. Choose a physical space that is quiet and free of interruptions. Try to set up in front of a neutral, nondistracting background. Interviewers will notice the physical space around the applicant and may even inquire about any artwork, photographs, or books that are visible, so applicants should be intentional about what is in view. Purchase or borrow a comfortable chair. Virtual interviews can require long days of sitting with upright posture, and an uncomfortable chair will quickly lead to backache and physical fatigue that could diminish interview performance. Test the lighting at different times of day. Additional lighting may be necessary to adequately illuminate the applicant's face and prevent unattractive facial shadowing. Ensure that the majority of the lighting is provided by a source behind the camera or computer. Minimize light behind the candidate, especially bright sunlight that can result in significant shadowing of the candidate's face. Ensure that the laptop camera or web camera is placed at eye level. This may require placing a laptop on a stand or books. Having the camera at eye level is more physically comfortable to maintain “eye contact” and also prevents distracting camera angles, such as up at the candidate's chin and down onto the top of their head. The interviewing space should have adequate electrical plugs, outlets, and chargers so that devices do not run out of battery power during the interview. Restlessness of the candidate or multiple adjustments of the camera or computer because of discomfort throughout the interview can be noticeable distractions during an interview Between sessions and during breaks, stretching and movement can be helpful to ensure that the candidate is comfortable during the actual interviews. If a candidate is unable to set up an adequate interviewing environment in their home, they may want to secure access to a faculty office or other workspace. Medical schools and residency programs may wish to create interviewing rooms for their trainees to ensure that individuals with fewer resources are not disadvantaged in the virtual interviewing process. Conducting a Technology Trial Run All applicants should conduct a technology trial run in advance of their first virtual interview to identify any necessary modifications in their physical space or technology upgrades that will allow for optimal interview performance. A trial run will also ensure that the applicant will become facile with the technology platform to avoid technical mishaps on the actual interview day. We suggest applicants test their technology with a colleague or mentor who will provide candid feedback about the applicant's interview environment, audiovisual quality, appearance, and mock interview performance including behavioral tics and eye contact. Applicants should create free accounts on virtual interviewing platforms such as Zoom or Google Meet to ensure their devices support interviewing software. When possible, trial the specific interviewing software in advance to view how the physical environment will seem to interviewers. Slight changes in lighting, camera angle, and chair height can result in dramatic changes to candidate appearance. Be sure to test attire/suiting, jewelry, makeup, and/or glasses. Glasses in particular may reflect the images from a computer monitor or lighting source, which may be distracting to interviewers. Use the speakers and microphone repeatedly to assess sound quality, sound volume, background noise, and/or feedback. Use the technology trial run to practice taking notes. Where is the ideal place for pen and paper? Ensure that the default name that is listed on the software platform when the applicant logs in is correct and not an informal or joke nickname. Consider the internet usage at the time of the actual interviews. If multiple individuals will be using the same network for virtual interviews, then interview quality may be diminished with an unstable or overloaded connection. Avoid using guest or public wireless networks for the virtual interview, as these may have bandwidth limits or specific time restrictions that will not allow for full day high quality video transmission. In addition to testing the technical aspects of virtual interviewing, we suggest applicants create a high-fidelity interview simulation that includes wearing a suit and practicing answering common interview questions regarding their career direction and motivation, professional accomplishments, clinical/research interests, and leadership style. Surgical educators may want to offer simulated interviews and dedicated time for feedback and reflection to help prepare their trainees to succeed on the virtual interview trail, just as they have offered mock interviews in the past.5 Cultivating Habits of Effective Virtual Interviewing Applicants should consider cultivating virtual interviewing habits that will allow them to participate in the interview experience in a way that will permit them to efficiently glean desired information and perform well without diminishing the interview experiences of other applicants. In large group settings, use the “mute” function to limit feedback and background noise that detracts from the speaker. Learn how to temporarily unmute using keyboard shortcuts to facilitate asking questions or interacting during the large group sessions. Be sure to suspend one's video feed before engaging in visually distracting behaviors such as getting up from one's chair, answering a phone call, or speaking to another person in the background. Use of virtual backgrounds should be limited or avoided. They often present an overly informal environment and can have distracting technological glitches that render the participant partially unseen. Be wary of the private chat function, as it is easy to inadvertently send a message intended for a single individual to the entire group. Plan snack, meal, and other breaks in advance based on the provided interview schedule. Learn how to take screenshots during presentations to take notes on programs without having to turn to pen and paper. Set audio so that screenshot taking does not produce a distracting “shutter” sound. Consider shrinking and dragging the interview software window to just below the laptop camera or web camera to facilitate making “eye contact” by looking into the camera rather than watching oneself speak. Minimize distracting behaviors such as gesticulation, touching face/hair/glasses/jewelry, and so on… Shut off cell phone and pagers. All of the standard interviewing advice for face-to-face interviews continue to be applicable to virtual interviews. Smiling, speaking clearly, maintaining eye contact, good posture, and active listening behaviors are all relevant interviewing habits to a digital interviewing platform. Table 1 is a checklist that may be helpful for applicants to ensure a smooth interviewing experience. TABLE 1 - Applicant Checklist and Reminders for Virtual Interviews Before interview season starts□ Select a reliably available and quiet physical space□ Invest in a comfortable chair□ Consider purchasing additional lighting□ Technology trial run Before start of interview□ Plan snacks and meals throughout the day□ Check items in view of background□ Electronic (laptop, phone) chargers plugged in□ Mute electronics (phone, pager) and browser tabs□ Ensure camera is at eye level□ Shrink and drag the interview software window to just below the laptop camera or web camera Reminders throughout interview• Maintain an upright posture• Mute mics when not speaking• Suspend video when engaging in visually distracting behavior• Double check the intended recipient for any message you’re sending (“Everyone” vs private messages to intended individuals) ADVICE TO PROGRAMS Just as we recommend that applicants thoughtfully and intentionally prepare for virtual interviews, we encourage programs to reflect on their planned interviewing practices to ensure that the goals of the interviewing process are met for all participants. Although the interview process is inherently a competitive selection and evaluation process in which programs discern between applicants, programs are simultaneously obligated to provide an informative interview experience that accurately depicts its formal and informal training characteristics so that applicants can make informed career decisions. The advice provided above regarding the physical setting of the interview and performing interview trial runs are also applicable to interviewing programs. Professionalism and technological familiarity can enhance the interview day and improve the applicant's perception of the program. Additionally, we suggest programs adopt interviewing “best practices” that grant applicants an equitable opportunity to showcase their strengths and accomplishments and that do not further disadvantage historically underrepresented and marginalized groups. Before the Interview Day Program impressions begin to be established long before the actual interview events. Pre-interview communication can both pique and diminish applicant interest in a program; therefore, programs will want to carefully consider the content and tone of all engagement with applicants from the beginning of the application process. Because applicants will be unable to visit programs in person, they will seek collateral sources of information about the program and may extrapolate details of the pre-interview process to inform their initial assessment and level of interest in the program. Programs may want to update their website, increasing the quantity of available information, and enhancing its visual appeal. Pre-recorded videos and welcome messages may help candidates learn about programs and hone their questions for the program in advance of the interview day. Social media accounts will also be additional sources of information as applicants form initial impressions of each training program. All interview-related events should be scheduled well in advance with generous notice so that applicants can adequately plan childcare, clinical coverage, acquire physical interviewing space, and so on… When possible, send the applicant's personal interview schedule in advance so the candidate can plan for meal breaks and read about faculty interviewers. Including a directory of faculty and current trainees with their photos and research/clinical interests will also help applicants prepare for their interviews. Interview schedules should be clear and easily interpretable. Ideally, applicants would just have to click a link to access interview events instead of having to manually type in long meeting IDs and passwords. Programs should use operating system agnostic meeting software and utilize a single platform for all of the interview activities, when possible. Applicants should be provided clear instruction on multiple backup methods of interviewing, including who to contact for technical assistance, and how. Programs may want to collect applicant cell phone numbers and whether they have alternative video call programs such as Facetime and Duo. To increase the fairness of the virtual interview process, programs may wish to send materials including virtual interviewing tips and advice to all applicants in advance of the interviews. Savvy applicants will notice details that demonstrate program caring. Programs should provide email addresses for participating interviewers. Applicants often like to express their gratitude for the interviewers’ time spent throughout the day, and tracking their contact information down can be difficult and time-consuming. Email friendliness and apparent competence of administrative staff will also likely influence applicant perspectives of a program. Disorganized and unempathetic communication may cause applicant concern that administrative support at a program is lacking. Programs may want to coach applicant-facing staff on how to project the program's best characteristics over this new, unfamiliar virtual interviewing process. Social Events One of the greatest sources of anxiety for applicants engaging in the virtual interviewing process is concern over diminished ability to assess program “fit.” Applicants typically gain insight into a program's culture and camaraderie at the informal portions of the interview experience such as the pre-interview cocktail reception and during meals. These events also serve as opportunities for applicants to ask questions to current trainees in less formal and scrutinized settings. Watching how current trainees/faculty interact with each other outside the context of a formal interview can affect how applicants assess a program's desirability. To limit the impact that virtual interviews have on these important aspects of the interview day, we suggest that programs design virtual social events in a way that enables applicants to learn about informal program elements. Training programs that create inviting and informative virtual social events will garner more applicant interest than programs that do not invest in recreating these informal interview experiences. Communicate in advance regarding social event attire, purpose and attendance. Applicants should be notified if the event will have faculty and current trainees, or trainees only. Additionally, applicants should receive advance notice if there will be any informational presentations as part of the social event. If the social event occurs during a meal or in the evening, programs should clarify for applicants if they are welcome to bring adult beverages, food, significant others, or children to the event. Programs may wish to solicit questions from applicants in advance so that faculty or current trainees have time to prepare answers or address topics of concern during the social event. Applicants may also submit questions using the real-time chat function of digital platforms. Effective social events have both large group and small group components. At the beginning of the social events, all applicants can receive a warm welcome and explanation of the mechanics of the social event, including how to obtain technical is important to that as to an in-person interview a virtual that applicants are not to and to each and this applicants less likely to in large group settings. We suggest a small group phase of the social event. Applicants may it to ask questions and in in and multiple rooms that can be to the to to specific program characteristics such as clinical training or also applicants to seek and gain the information that is to Applicants should have the opportunity to in multiple small across the of the event to gain perspectives on the program. software programs have or that can that they will be to a new small group. 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Be up front about program characteristics including of trainees, of other of including of trainee formal and leadership of recent trainees, and so on… address program This prevents applicants from having to ask uncomfortable questions and that the program insight into the applicant Programs may to address of trainees, volume, clinical and/or address topics such as call for Medical and access to without applicant to and and how a program the of and are additional topics that should be to all applicants. faculty and trainees to create audiovisual materials and videos that demonstrate the culture and of the program. do not applicants about physical use of virtual video that trainee and so on… Applicants will also be to what their outside the would be like at a training program. information regarding and and common of and images of trainee and will all help applicants in a new a food, and will also applicants in which programs their Although it significant to create a informative virtual interview day, the will likely be as applicants the programs make to provide interview experiences. programs should provide contact information for faculty and so that applicants are to seek additional Conducting Interviews The of the virtual interview experience is the interviews Programs will likely have to and their in-person interviewing processes for the virtual When we suggest practices that limit and create opportunities for all applicants to interview at their Applicants should have clear on when their interviews will with and how to access the virtual interview to obtain technical and backup methods of interviewing should also be to applicants in Applicants may also from a to the interview, such as their time and of interviewers. Programs should take advantage of software that prevent applicants from inadvertently another candidate's interview. the small group or interview are all methods to ensure applicants receive their of interviewing practices that limit such as questions and/or interview clear time and multiple Interviewers should be with applicant materials such as and personal in advance of the interview. should be an opportunity to ask questions at the of the interview or provide on their should be regarding questions regarding and or personal if these of questions should not be in the interview process as they can be by applicants as that an environment, especially for and other marginalized groups. behaviors such as the applicant by them for taking the time to interview, and them on their accomplishments can applicants at and an environment in which they can accurately demonstrate their all of the interview process, programs should be that applicants will be on from multiple time and may want to consider how to the interview schedule to minimize the to applicants across geographic programs may want to schedule applicants from the during interview sessions so that applicants in and the do not have to interview during what is is critical that all communication about interview times and events the time of the tips for applicants are relevant to the faculty interviewers. and programs may want to require that the virtual interview process to ensure that faculty are of using the digital interview software in an optimal physical The pandemic dramatically the residency and fellowship interview process. is likely that web-based, virtual interviews will be the standard for the foreseeable and likely to impact all interviews The recommendations provided are based on recent experience with this new and may serve as a for applicants and surgical programs. This is not intended to be a as each applicant and program will to in their and may an for the best practices of virtual interviewing. In the both applicants and programs can take several to optimize the virtual interview day in a way that applicants to their of well relevant program

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