Six interview practices to improve family medicine Match success

By David Mitchell

The day family medicine residency programs begin reviewing applications— and sending interview invitations—in September is a bit like a Taylor Swift concert presale: Thousands of young people across the country are glued to their phones or devices waiting for an opportunity to pounce on that golden ticket.

Except, with all due respect to Swift, there’s much more at stake.

“Students tell me they'll be on one phone, and then they'll have a parent or another loved one on a laptop, and then they'll have somebody else on another device,” said Sarah Cole, DO, FAAFP, program director of the Mercy Family Medicine Residency in St. Louis. “It's not necessarily the applicant who's accepting that invitation. It's their mom, dad, partner or whoever, just accepting whatever comes through willy-nilly because there's so much fear of a missed interview invitation going to another applicant.”

Cole said medical students on rotations will take days off as interview scheduling begins so they can focus on monitoring their texts or email. Those who do come in often feel compelled to step out of rounds as their phones ring or ping.

“I can't imagine the pressure of going through that,” said Cole, a participant in the AAFP’s Residency Selection Improvement Initiative. “Slowing things down will help medical students take a more thoughtful approach. It might take a year or two to reset the culture, but it starts with these initiatives. I hope it's going to be great.”

Despite a record number of family medicine residency positions being offered each year in the National Resident Matching Program Main Residency Match, hundreds of positions remain unfilled before the Supplemental Offer and Acceptance Program. In August 2025, the Academy launched RSII in August 2025 to identify improvements that could be put in place within a year or two to help fill more family medicine positions in the Main Match as effectively, efficiently and economically as possible.

In January, the initiative identified steps to be implemented for the 2027 Match cycle intended to benefit applicants and programs. Now the initiative has produced an interview guideline with six recommendations to improve the process.

In this post, Cole and AAFP Vice President for National Residency and Academic Partnerships Karen Mitchell, MD, FAAFP — both past presidents of the Association of Family Medicine Residency Directors — discuss six myths and realities about residency interviews and how the new guidelines will help.

Reality: Aligning interview invitations with capacity creates a more efficient recruitment process.

Many programs assume that offering more interview invitations than available interview slots is necessary to ensure a full schedule. In reality, over-inviting often creates scheduling uncertainty, administrative burden and frustration for applicants.

Mitchell said the new guideline’s direction for programs to offer only as many invitations as interview spots available is in alignment with NRMP rules.

“We are overtly stating it for family medicine as has been done in other specialties,” she said. “If a program offers more interviews than the number of interview slots it has available, it creates unnecessary competition between applicants. If an applicant receives an interview offer, they should be able to schedule that interview.”

Reality: Aligning interview invitations with capacity creates a more efficient recruitment process.

Many programs assume that offering more interview invitations than available interview slots is necessary to ensure a full schedule. In reality, over-inviting often creates scheduling uncertainty, administrative burden and frustration for applicants.

The new guidelines direct programs to release initial interview invitations no sooner than one week after applications are released to programs.

“We want programs to take more time to review applicants in a mission- aligned way,” Mitchell said. “When programs offer interviews as soon as applications are available to programs, applicants feel pressure to respond immediately. Programs should extend invitations to those most likely to actually match with the program. Programs can have a competitive mindset that if they get interview offers out early, they will have a better chance of appealing to applicants. However, when an applicant is mission-aligned with a program they will still accept interview applications from programs they really want at later dates.”

Cole said the change is important because an increasing number of applicants are using the interview process to help them select a specialty.

“Applicants may be applying to more specialties when ERAS opens in September than they are actually putting on their rank list when NRMP ranking opens in February,” she said. “If programs take the time to be thoughtful about which applicants they are going to invite to interview, they can really be much more discerning in selecting applicants with a deeper commitment to family medicine.”

Reality: A two-day response window encourages more thoughtful decisions

When applicants fear losing opportunities, they often accept every interview invitation they receive.

Mitchell said allowing applicants two business days to consider interview offers will alleviate pressure for them to respond immediately and frees them from feeling tied to their phones and devices to watch for offers.

Cole agreed.

“Not only have we improved thoughtful decision making by programs, we're giving space for applicants to make thoughtful decisions as well,” she said. “It’s about increasing the likelihood of getting an interview with the applicant who truly wants to come to your program.”

Reality: Clear cancellation expectations improve interview access and efficiency.

Last-minute cancellations can create significant challenges for residency programs and applicants waiting for opportunities.

The new guidelines call for applicants to give two-weeks notice when canceling an interview. Mitchell said the change sets an expectation for applicants to help meet everyone’s needs and optimize all interview slots.

Cole said her program has used Thalamus, the interview scheduling platform, to limit the window in which an applicant can cancel an interview online without talking directly to the program.

“This is something we have wrestled with as a program,” she said. “Two years ago, we said, ‘We'll give people five days because we recognize that a life event or an emergency could come up, and we didn't want to penalize somebody.’ Last year, we went to seven days. I'm delighted to see this specialty-wide recommendation asking applicants to give at least two-weeks notice. I think that aligns with professionalism values. It also offers me as a program director the opportunity to turn around in a thoughtful way and invite another applicant to that interview spot.”

Cole said applicants who are interested in a program but cannot keep a scheduled interview should contact the program directly.

“Last year we had enough people who contacted us directly within our window to say, ‘I can't make it, but I'm still highly interested. Do you have another option?’” she said. “We ended up opening another half day of interviews, and we ranked all of them. It was well worth our time. This offers an opportunity for a program to make a personal connection, when the applicant has to reach out, to gauge the authenticity of their interest.”

Reality: Timely communication benefits both applicants and programs.

Many applicants spend months waiting to hear whether they remain under consideration.

The new guidelines call for programs to notify applicants by Dec. 1 if they intend to place an applicant on a wait list or do not intend to offer them an interview.

“This allows applicants to make decisions, regroup and proceed,” Mitchell said.

Cole said it was common courtesy for a program to let an applicant know where they stand by a specific date, but reaching a large number of applicants in an efficient manner has been a barrier for some programs. To address that need, AFMRD has created sample verbiage that can be used in batch messaging, and the organization is planning a webinar related to such messaging.

Reality: Flexibility expands access while preserving meaningful program experiences

Some programs view virtual and in-person interview options as competing approaches. In practice, both can serve important purposes.

Mitchell said programs can determine for themselves the best method for interviews given their specific situations, but the guidelines state that programs should clearly specify the available options on their websites and application materials.

“We have found that an in-person experience is more likely to lead to a match,” she said, “but we encourage some virtual interviews for applicants who lack resources or time to visit in person.”

Studies have shown that there is an inherent bias in favor of applicants who interview in person when both in-person and virtual interviews are offered. However, there are steps that can mitigate that bias, Cole said. For example, one best practice is to conduct identical presentations regardless of interview format.

“Interviews should last the same amount of time, be conducted with the same number of individuals, asking the same questions and presenting the same information,” Cole said. “If you're giving swag bags or curricular materials, mail it to the people who are interviewing virtually. This recommendation fosters equity for applicants while increasing the range of applicants a program can host.”

While each recommendation addresses a specific aspect of the interview process, they all support a common goal: helping programs connect with applicants who are most likely to thrive in—and rank—their programs.

With the next recruitment cycle approaching, Mitchell and Cole urged residency programs to act now by reviewing current interview practices, implementing these recommendations, and refining selection criteria to prioritize mission-aligned applicants most likely to thrive in their programs.