As a fourth-year medical student, I would like to use this letter to discuss an aspect of the residency interview scheduling process that has unintended ramifications for medical student education and quality of life.

In general, residency programs send out interview invitations in batches, provide several scheduling options, and tell students that their scheduling requests will be honored on a first-come-first-serve basis. Thus, via both formal and informal channels, students are explicitly encouraged to attend as soon as possible to every vibration in their pockets and to respond as soon as possible to those which turn out to be interview invitations.

The way I see it, this procedure leads to a number of undesirable consequences—both inside and outside the educational workplace. For example:

  • I have seen fourth-year students think twice before choosing rural rotations during interview season for fear of poor cell service, and I have seen students worry about choosing surgery rotations during interview season for fear of long operating room cases.

  • The student who interrupts a patient interview to immediately answer an e-mail is rewarded while the student who continues the interview may miss out.

  • The student who interrupts a family dinner to answer an e-mail could get the coveted interview, while the student who stays at the table may miss out.

  • And last but certainly not least, there is the fourth-year student who interrupts his or her attention from the road while driving.

As this process affects nearly 20 000 students for 2 to 3 months each year, I believe the graduate medical education community has an educational and humanistic duty to address the aspects of interview scheduling that produce or contribute to these undesirable consequences.

Here is a proposal. Let us assume a residency program sends out a batch of 50 interview invitations and provides 10 scheduling options. Each of those 50 students would be instructed to, within x many hours (I think 24 to 48 hours is reasonable), submit a ranked list of his or her scheduling preferences. At the end of the given time frame, an algorithm would be run such that those 50 students are randomly ordered from 1 to 50. Student No. 1 would then be assigned his or her highest-ranked available choice, student No. 2 his or her highest-ranked available choice, and so on. Any students who did not submit a ranked list within the given time frame would then schedule their interviews on a first-come-first-serve basis. Of note, the algorithm could (at least theoretically) be integrated into the “Interview Broker” if/when it becomes the centralized interview scheduling platform.

In summary, the message to students would shift from “reply as soon as possible” to “as long as you reply within the given time frame, you will be no better or worse off than everyone else.”

And with that message alone, I believe there would be a meaningful change for the better—both inside and outside the educational workplace.