September 16, 2022, 10:11 a.m. David Mitchell — The AAFP’s recent webinar on applying to family medicine residencies (which is now available on demand) drew a large audience and generated far more questions from U.S. and international students and graduates than an expert panel could answer in the time allotted.
AAFP News got answers to more students’ questions in this Q&A with Kristina Diaz, M.D., director of the family and community medicine residency program at Yuma Regional Medical Center and president-elect of the Association of Family Medicine Residency Directors. Watch AAFP News later this month for another Q&A with two new residents who went through the Match this year.
AAFP News: Did the change to hybrid interviewing make applying to family medicine programs more competitive?
Diaz: We, as program directors, have been having this discussion for a long time. Specifically, there are some students accepting a lot of interviews because with the virtual model, it’s a little bit easier to see a program than it is to go to an in-person interview. Programs have seen an increased number of applications and an increase in the number of students who are willing to accept interviews all over the country.
Should this impact the number of programs students are applying to? I would say, make good decisions on where you want to apply, make sure that you express your interest and that you are a good fit for that program. Apply to programs that you know for sure you would fit in or that you’re really interested in going to.
Applying to every family medicine program in the United States doesn’t improve chances when all the students do that. Make smart, targeted choices on where you’re applying.
AAFP News: If programs are doing both virtual and in-person interviews, does either format make a candidate more memorable?
Diaz: We, as program directors, also have been talking about that and making sure that whatever the experience is, that we create equitable experiences for all candidates. AFMRD has sent out recommendations to programs to make sure that they are clear about how they’re going to be interviewing students. Specifically, will there be an in-person and a virtual option, or are they only doing one or the other? Are they expressing whether or not being in person will give an extra bonus to their interview and selection possibilities?
Most program directors I have spoken with want to create an equitable experience for students. For our program, we’ve decided to go 60% virtual and 40% in person and are allowing students to choose. We don’t want a student to not interview with us because of money or just the inability to travel because of a rotation, so we’re letting the students choose which option works better with their schedules.
However, every program is choosing which option they want to do, so there’s not a uniform answer about whether virtual will be better than in person. For us, for example, coming back to do a tour of our hospital or coming to any of the mixers is not playing into an interview score.
AAFP News: How can applicants get a good feel for a program’s culture when many interviews will be virtual?
Diaz: To stand out and to figure out the culture in a virtual environment, attend things like mixers. Or maybe a program has a virtual tour online. Speak with the residents when there’s not faculty around so that you can see the vibe and ask the questions that you need to determine if that program is going to be a good fit.
As a program director, I may love you as a candidate, but if you don’t feel comfortable with us, I don’t want you to feel the next three years are going to be miserable for you. I absolutely encourage applicants to do the culture investigation. That’s a big one for me because you need to go somewhere that you’ll fit.
Most programs have social media accounts, or they may have a website with videos on them. That’s going to be a good place initially to see the vibe of the program. Ultimately, it’s going to come down to talking to residents.
AAFP News: When you mention mixers, you’re talking about online events?
Diaz: Yes. Before you interview with us, we have an event where people can get online and our residents do a quick intro to the program. They do an icebreaker, and then candidates can speak candidly with the residents without faculty our admin staff on the line. That’s a great opportunity. You can see how people interact with each other. You can ask residents questions, and one of the questions I appreciate when people ask me is, how do you deal with a struggling learner or a resident who is having a little difficulty?
I think that shows a lot of what the culture can do. I think asking residents to tell you an example of when they felt most supported by the program can tell you a lot.
AAFP News: Is it OK to ask for an in-person visit in a virtual interview process?
Diaz: I think each program is going to attack that a little differently. Our program is not encouraging those kind of interactions, but just like each program is choosing their own adventure with doing virtual, in-person or hybrid interviewing, each program may have a different flavor on how they’re going to allow those kinds of interactions.
AAFP News: So, students should ask that question on a case-by-case basis?
Diaz: Definitely. But if you are interested and you do want to talk to somebody, it’s totally OK to talk to the program coordinator and see if that’s something that they’re offering. But don’t feel like they’re not interested in you if they don’t offer that interaction. They just may be interviewing hundreds of people and don’t have the time to then spend another half day with each one of those applicants.
AAFP News: Do family medicine programs invite more applicants to interview than their number of interview slots can accommodate?
Diaz: The AFMRD suggests that programs be transparent with that exact question.
There are programs out there that, let’s say they have 30 interview slots. Then they are inviting 40 or 50 people all at once. Then the first 30 that return their phone call are the ones that get the interviews. What our program has chosen to do is offer the number of interview slots we have available and give the applicants a certain period of time to respond. If they don’t, then we will assume that they do not want to come to us, and we will then release that interview slot to somebody on our waiting list. We will be clear with that communication when we send out our invitation to interview.
For all applicants who are waiting to receive invitations, it’s very important that you’re timely with your response to a program because one, they may be waiting to offer that slot to someone else if you’re not interested. Two, they want to make sure that you’ve received that email.
During interview season, it’s really important that students are actively checking email and are involved with the interview invitations or denials, so that they can communicate well with the programs.
AAFP News: Programs will start reviewing applications submitted through the Electronic Residency Application Service on Sept. 28. How quickly should students expect to hear from programs, and will they be given dates to choose from?
Diaz: When it opens, all the programs are going to do a mad dash to review applications. But remember that I’m going to receive, hopefully, a good number of applications.
It’s going to take us a week or two to go through that selection process. Within a week, some programs may start interacting with students, and it may take others three or four weeks. It’s going to depend on a program’s resources available to review applications and an admin’s capability to get out some of those interview opportunities.
Just because you didn’t get anything the day after it opens, that doesn’t mean a program isn’t interested in you. Give them a little bit of time to review applications.
We have chosen to use the ERAS scheduler. Once we invite you for an interview, you can see all of the interview days and times that are available to our applicants. And then they can self-schedule, and that can be done at 10 o’clock at night or after hours.
Some programs, you call them to schedule. We’ve done that version before’ as well. We would send you an email with an invitation and say, please call our coordinator to schedule. So, again, each program will do its own flavor. There’s not a standard process across the board for that.
AAFP News: What are your thoughts on students following up after an interview?
Diaz: It’s encouraged to send a thank you note to the people that you interviewed with and maybe highlight some of your most stand-out interactions. I always love receiving messages like, “Hey, it was great talking to you, Dr. Diaz, about inpatient medicine. That’s my passion. That’s what I want to do.” Be specific about your interactions with people.
Then it’s totally OK to follow up again after you’re done with all your interviews. If you really like them, email them and say, “I’ve completed my interviews. I really enjoyed my time at Yuma Regional Medical Center, and I still would like to join your program.” It keeps your name and the interaction at the top of mind and shows a lot of engagement with the program.
AAFP News: When you say, “thank you note,” do you mean actual mail or an email?
Diaz: Either. Email is just as well received as a handwritten letter. At least for me, it doesn’t matter.
AAFP News: You’ve experienced the Match as both a program director and an international medical graduate. What are the key factors for an IMG to be successful in matching in family medicine?
Diaz: Their application absolutely needs to demonstrate their passion and commitment to family medicine. We can read between the lines whether you’re submitting a generic application to 10 different specialties, or whether you are really targeted and passionate about family medicine.
I will assume that people who are reading this article are already passionate about family medicine because they’re looking to the AAFP for guidance, but saying things like, “I attended AAFP National Conference,” or “I’m part of the family medicine interest group where I’ve volunteered at this X,Y, Z thing” helps.
But they absolutely need to have a strong demonstration of their passion and commitment to family medicine.
AAFP News: How do program directors view international medical graduates in the Match who have been out of school for more than a year or two?
Diaz: The longer you’re away from clinical practice and school, it does become more challenging. If you’ve been out a year, it’s important to demonstrate what you have been doing. How have you remained clinically active and kept your medical knowledge up? The further away from graduation as an IMG, the more difficult it becomes.
AAFP News: What if someone had a baby, was a caregiver for a family member or has a similar reason for not matching the previous year?
Diaz: Yes. Or, “I took the year and I became a scribe for a physician.” So, you’re still staying clinically active. Or, “I started doing research at this hospital,” or, “I started volunteering.”
Be active. Sitting on Mom and Dad’s couch for a year waiting to match does not demonstrate continued commitment to your career. Make sure that it’s apparent what you’ve been doing and why. Having babies, life events and even if you didn’t match, that’s OK. “I didn’t match last year, and I’ve spent the last year being clinically active doing X, Y and Z.”
AAFP News: What’s your advice for students who need visas during Match?
Diaz: There’s some concern of, “Am I sending the wrong signal if I need an H1B versus a J1?” Honestly, you just need to be transparent about what you need.
Some programs are not going to sponsor visas. It’s going to be up to that program to decide if they can. It has to do a lot with the IMG’s originating country.
Some programs will filter based on what kind of visa they need, but I wouldn’t be worried about that right now. I would just be totally transparent about what you need because you wouldn’t want to match into a program and not have shared that you need an H1B versus a J1 and then not be able to honor that.