American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Clinical Updates

Virtual Interviews in Plastic Surgery

by Benjamin A. Sarac, MD; Jeffrey E. Janis, MD, FACS, The Ohio State University Wexner Medical Center Department of Plastic and Reconstructive Surgery

The Coalition for Physician Accountability1 and the American Council of Academic Plastic Surgeons2 recommended that residency interviews for the 2020–2021 application cycle be conducted virtually. Virtual interviews are not a new concept, but their results have been sparsely reported in a variety of specialties. Hence, for many residents, virtual interviews are an entirely new experience during an unprecedented time, when much is changing in medical education. As such, our group sought to characterize the entire process of virtual interviews in plastic surgery, from optimizing how applicants can put their best foot forward to what both the applicants and program directors preferred and experienced during this new process.

Optimization and Preparation

Prior to the commencement of virtual interviews, we wrote about how applicants can optimize their virtual interview experience through three domains: environment and background, audio/visual and interview etiquette.3 Largely, virtual interviews should be approached in a similar manner as in-person interviews. Applicants should arrive early; remain engaged and professional throughout; make good eye contact; and, most importantly, eliminate any potential distractions. We have, however, heard reports of the virtual format leading to applicants arriving unkempt or "too relaxed" in comparison to in-person interviews. This notion is purely anecdotal, though, and does not yet have data to back such claims.

Applicant Perspective

Following the completion of integrated plastic surgery interviews, we surveyed applicants at different points in time to address various aspects of the process. First, we sought to understand applicant preferences on specific modalities and types of interview days to help aid programs in planning for future virtual interviews, if necessary.4 Most respondents agreed that pre-interview socials were beneficial and were most helpful when they lasted an hour or less and had small theme-based breakout rooms (where to live, rotation schedule and so on). Further, on interview day applicants were least familiar with the program, its people, and location when the duration of the day was less than three hours, rather than three to seven hours or more than seven hours.

Applicants were later surveyed after rank list submission to help better characterize the overall virtual interview process.5 Most respondents were satisfied with virtual interviews, though if given the choice, more than 70 percent would have preferred in-person interviews. In addition, 60 percent of respondents reported that they were able to attend more interviews than they would have if interviews were in person, which highlights an advantage of the virtual format for strong applicants with many interviews. Finally, nearly 90 percent reported spending less than $500 on interview-related costs, which is significantly less than what our group has previously reported of more than $6,500 during the interview season.6

Program Director Perspective

To further understand the process from the other side, program directors (PDs) of integrated plastic surgery programs also were surveyed.7 Thirty-seven percent of programs increased the number of interview slots during the virtual interview season, for a specialty-wide increase of four interview slots per available position. Most notably, 67.8 percent of respondents reported being satisfied (15.3 percent extremely satisfied, 52.5 percent somewhat satisfied) with the virtual interview process. However, 76.3 percent preferred in-person interviews, which matches the previously mentioned applicant data.

Interview Invitation Distribution

The 2020–2021 application cycle with virtual interviews created many changes from traditional in-person interviews. This shift coincided with several potential benefits, including decreased cost and increased flexibility without the need for travel for ease of scheduling. However, these advantages allowed the highest tier of applicants to attend nearly as many interviews as they were offered, commonly referred to as "interview hoarding." This potentially eliminates "the trickle," in which lower tiers of applicants are offered interviews that the higher tiers decline.8 The concept of interview hoarding was further discussed by the Association of American Medical Colleges, which, in an open letter, urged applicants to accept only as many interview invitations as needed.9 In a free response section at the end of our PD survey, three respondents suggested a "cap" on the number of interviews an applicant can attend to combat hoarding; in the applicant survey, 68 percent responded "yes," when asked if the number of interviews an applicant can attend should be limited. The rationale driving this notion is that the cap would decrease interview hoarding, and thus increase the trickle. However, no integrated plastic surgery program had an unfilled position in the 2021 match, questioning the need for a cap. This concept should be explored further to better understand its potential benefits in relation to interview hoarding and equitable interview distribution.

Future Directions

The future of virtual residency interviews is unknown. A hybrid virtual and/or in-person interview system is an option, though it should be organized carefully. Individual programs should balance the pros and cons of each modality with their ability to recruit the best residents for their programs while remaining considerate of each applicant's time and expenses. Long-term data regarding the satisfaction of both programs and residents with respect to their rank lists following the 2020–2021 virtual application cycle is paramount, as this information will guide the future of the residency interview and match process.


  1. The Coalition for Physician Accountability's Work Group on Medical Students in the Class of 2021 Moving Across Institutions for Post Graduate Training. Final Report and Recommendations for Medical Education Institutions of LCME-Accredited, U.S. Osteopathic, and Non-U.S. Medical School Applicants 2020. Available at: Accessed May 26, 2021.
  2. American Council of Academic Plastic Surgeons. Important COVID-19 related announcements. May 2020. Available at: Accessed May 26, 2021.
  3. Sarac BA, Calamari K, Janis J. Virtual residency interviews: Optimization for applicants. Cureus. 2020;12(10):e11170.
  4. Hemal K, Sarac BA, Boyd CJ, Runyan CM, Gosman AA, Janis JE. Applicant Preferences for Virtual Interviews: Insights From the 2020-21 Integrated Plastic Surgery Application Cycle. Accepted. Plastic and Reconstructive Surgery - Global Open. 2021.
  5. Shen AH, Shiah E, Sarac BA, et al. Plastic Surgery Residency Applicants' Perceptions of a Virtual Interview Cycle. Submitted. Plastic and Reconstructive Surgery. 2021.
  6. Sarac BA, Rangwani SM, Schoenbrunner AR, Drolet BC, Janis JE. The cost of applying to integrated plastic surgery residency. Plast Reconstr Surg Glob Open. 2021;9(1):e3317.
  7. Sarac BA, Shen AH, Nassar AH, et al. Virtual interviews for the integrated plastic surgery residency match: The program director perspective. Accepted. Plastic and Reconstructive Surgery - Global Open. 2021.
  8. Boyd CJ, Ananthasekar S, Vernon R, King TW, Saadeh PB. Interview hoarding: Disparities in the integrated plastic surgery application cycle in the COVID-19 pandemic. Ann Plast Surg. March 4, 2021.
  9. Whelan A. Open letter on residency interviews. December 18, 2020. Available at: Accessed May 26, 2021.