A New Approach: Virtual Forum for Anesthesiology Residency Applicants in the 2021 Match Cycle

Authors: Scott Lewis, MD¹, Lia K. Metzger, MD², Christine Colasacco, MS-2³, Mathias Palmer, MD⁴, Garret Weber, MD⁵, A. Elisabeth Abramowicz, MD, FASA⁵

Institution: California Pacific Med Center¹, Beth Israel Deaconess Medical Center ², New York Medical College³, Mayo Clinic⁴, Westchester Medical Center/New York Medical College⁵

Introduction:

With the 2022 Match application season approaching, it may be time to reflect on the all-virtual 2021 efforts to help applicants select the best-fit programs. Although some away rotations will take place during the current application cycle, we still do not know whether interviews will continue exclusively on virtual platforms. As we consider what worked well during last year’s improvised recruitment procedures, we want to share a perspective on our institution’s initiative, which we named Virtual Forum for Anesthesiology Residency Applicants. Unlike the format of a virtual open house, the forum meant to introduce the applicants to multiple, independent, diverse Programs in a way that allows strictly informational, anonymous “visits” and questions.

Last year, during the pandemic, two fourth-year New York Medical College students and AIG executive board members were brainstorming ways to learn about the application process and become familiar with programs’ characteristics and culture. Aided by their advisors and another student with technical know-how, they conceived the idea of live-streamed, Virtual Forums for applicants, featuring 3 to 4 Program Directors (PDs) and up to two residents from each Program per 60 to 75 minute session. From August 25 to October 14, we held four such Forums, featuring a total of 14 Programs: 10 from the New York Metropolitan Area and 4 from the West Coast.

The Virtual Forum format intended to help applicants learn about and develop an interest in featured programs early in the application process, while saving research time. It encouraged probing questions by ensuring anonymity of participating prospective applicants, and sought to motivate Programs to discuss, in a transparent fashion, how they intend to identify applicants of interest in a virtual-only environment in a year when both clinical and research opportunities were curtailed. Furthermore, the Resident-representatives could field questions on resident life and support systems. As an additional advantage of the forum, we thought Program Directors would benefit by hearing in real time the most frequently expressed, sincere concerns of anonymous participants. 

Leveraging the utilized technology, we generated many data points used to refine each subsequent session.

Purpose:

The aim was to provide Anesthesiology applicants with an opportunity to get to know a number and variety of programs despite the limitations imposed by the Covid-19 pandemic. Given the lack of visiting rotations and in-person exposure, we conceived this format to provide applicants a free, accessible, and interactive way to gain information directly from the Program Directors while forming an opinion of each program’s culture.

Format:

The virtual forum series consisted of four panels with program directors and residents from sites in the New York area and the West Coast; PDs were either invited or volunteered to participate after learning of the initiative. Panelists interacted with the forum via Zoom while attendees viewed a live stream of the meeting on YouTube and used Slido, an interactive polling application, to propose and vote on questions for PDs to address. PDs were allotted time to introduce their Program, followed by a Q&A session.

The Q&A session was divided into two segments. The first segment consisted of questions submitted in advance that were reviewed and selected by the event organizers based on recurring themes. The second Q&A segment was reserved for proposed questions that received the most live votes on Slido from virtual attendees. Due to time constraints, the participating PDs and residents answered only the questions with the most votes.

Audience Recruitment:

To facilitate attendee recruitment, the event/series organizers built a webpage. Wix.com provides template-based website design and hosting services with integrated event registration tools complete with email marketing capabilities. The site was visited 2,415 times by an estimated 1,610 unique visitors.

The top traffic source (1,686 sessions) accessed the webpage via a direct link. That a direct link was published only on the ASA’s list of Residency Programs Virtual Open Houses is indicative of the reach and power of this resource. The paucity of traffic generated by Facebook (94 sessions) and Instagram (61 sessions) and Twitter is likely a result of low numbers of followers. Additionally, no investment in advertising on social media or other forms of media was made.

Attendance:

Forum session attendance was measured using YouTube analytics. A total of 2,441 views were recorded across the four events with approximately 1,850 unique viewers [accurate data is stored for 90 days only; the estimate is derived by adding unique viewers by week from 8.23.2020 to 6.26.2021. A “week” starts on a Sunday and ends on a Saturday]. The average number of live viewers was 163, with the highest live attendance of 258 at the first event and lowest, 94, at the last.

Of note, the Electronic Residency Application Service (ERAS) opened for application submission on September 1, 2020 and released applications and MSPE’s to programs on October 21, 2020.

Table 1. Number of Forum Viewers on YouTube

1. Estimated by adding unique viewers by week from 8.23.20 to 6.25.21

Questions:

Over 100 questions were submitted by registered attendees via Google Forms. At the time of submission, questions were grouped into one of six categories: program specific, application details, resident life, virtual interviews, opportunities to show interest, or other. All questions were reviewed by the event organizers. Duplicate questions were annotated as a recurring theme and once recorded as a vote, they were removed from the final list of questions. Recurring themes included: application process changes (i.e. new interview formats, changes to USMLE exams), applicant characteristics valued by programs, and how program directors will change their approach to assessing applicants.

Table 2. Questions Voted on Via Slido by Applicants

Panelists and Residency Site by Forum Date:

1st panel, August 25, 2020
Michael Wajda, MD – NYU Grossman School of Medicine, NY
David Wlody, MD, FASA - SUNY Downstate, Brooklyn, NY
Bryan Mahoney, MD, FASA - Mount Sinai West and Mount Sinai Morningside, New York, NY

2nd panel, September 15, 2020
A. Elisabeth Abramowicz, MD, FASA - Westchester Medical Center/ New York Medical College, Valhalla, NY
Rotem Naftalovich, MD, MBA - Rutgers New Jersey Medical School, Newark, NJ
Judith Aronsohn, MD – D. and B. Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY
Sujatha Ramachandran, MD, MACM - Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY

3rd panel, October 7, 2020
Michael Block, MD - Hackensack University Medical Center, Hackensack, NJ
Seth Landa, MD - St. Joseph’s University Medical Center, Paterson, NJ
Michael Girshin, MD - Metropolitan Hospital Center/New York Medical College , New York, NY

4th panel, October 14, 2020
Helen Bean, DO - Virginia Mason Medical Center, Seattle, WA
Pedro Tanaka, MD, PhD, MACM - Stanford University School of Medicine, Palo Alto, CA
Chelsia Jackson, MD - Keck School of Medicine, University of Southern California, Los Angeles, CA
Benjamin Beal, MD - UC San Diego School of Medicine, San Diego, CA

Viewer Feedback:

Overall feedback to the YouTube live stream and availability of the recording were positive. However, some respondents noted in the post-event survey that Zoom would have been preferable. Additional feedback indicated that break out rooms with each program would have been beneficial.

Regarding the use of a webinar audience engagement tool, Slido, feedback was consistently positive. One respondent stated: “Having the questions beforehand and then having students rate the questions to see which ones were most popular was helpful and appreciated.” One respondent expressed concern that “the voting system may be flawed in that a question that may arise in the middle of the session will not be voted to the top and will not be asked.”

Technical Considerations:

We selected YouTube Live Stream as the medium for broadcast due to capacity limit of 100 participants on Zoom. A business or enterprise level license is required to host up to 300 and 500 participants, respectively. Of note, all forums exceeded the Zoom meeting attendee maximum when accounting for panelists and coordinators (8 to 14 individuals).

A free, open-source application called OBS facilitated the broadcast to YouTube. Integrated live streaming with the Zoom application requires a Pro, Business, Education, or Enterprise account license.

For best video quality a separate, live-stream ready computer was utilized to broadcast the Zoom meeting to YouTube, using an Ethernet cable connection to the internet with confirmed greater than 100 Mbps upload and download speeds.

Recommendations for Future Virtual Events:

Why participate in and/or host a Virtual Forum?

The virtual forums were distinctly different from “traditional” virtual open houses. They included multiple programs at once, allowing for variety and perspective, and a good use of time. Virtual panels also allow for flexibility with how questions are collected, giving the option for audience members to continue to ask questions and support their colleagues’ questions in real time. Most importantly, most applicants have historically not been able to visit programs in person prior to interviews, and out of necessity, there arose an option for all applicants to have the same access to asking important questions of program directors and “meeting” key members of the leadership. Those unable to attend during the time allotted could view the available recordings accessible via provided links.

Increase Interaction Between Applicants and Program Directors:

In Zoom formats, individuals who speak up are able to receive answers, but many students do not feel comfortable asking their questions. With the Slido/pre-submitted format, program directors are able to review questions prior to the session and answer questions that will benefit a larger applicant pool. Questions can also remain anonymous so that applicants can feel confident that their questions can be asked without potentially biasing their own application. Live polling of the audience is another way where program directors can get a sense of the applicants. Questions such as “how many programs do you expect to apply to” can help program directors navigate the process as it evolves each year.

Avoid “Zoom Fatigue”:

Many students are exhausted by virtual events and/or cannot make it to the program-led sessions that happen 1-2 times during the pre-application season. Multi-program, livestream forums under 90 minutes in length help reduce fatigue and published recordings allow for access regardless of schedule conflicts.

Candid Transparency:

Through forums with moderators, the applicants can put a face to the names on the program websites. They can gain a sense for who their co-residents will be by getting to know the residents included in the panel. Many applicants come well-prepared from reading program websites, but websites cannot capture the “vibe” of a program. In a world with increasing access to information on the internet, “live”, interactive events become an established way to maintain transparency throughout the interview process.

Links:

Event Website: https://aignymc.wixsite.com/mysite
Slido: https://www.sli.do/