APPD/CoPS/AMSPDC Letter to Residency Program Directors and

APPD/CoPS/AMSPDC Letter to Residency Program Directors and Advisors of Fellowship Applicants

Regarding the Fellowship Recruitment Process

May 21, 2024

The leadership of APPD, CoPS, and AMSPDC have been working with fellowship and residency leaders,

and trainees to optimize the fellowship recruitment process for applicants and programs. Through this

process, we sought substantial input from studies, applicants, program leaders, chairs, the greater

pediatric community and other specialties. Additionally, we reviewed and appreciate the 2023

recommendations from AAMC and AACOM on this subject.

The pandemic and requirement for virtual interviews revealed gaps in the recruitment process, most

importantly in equity. This led to a number of studies, the data from which, along with our increasing

experiences in virtual recruitment, continue to inform current recruitment recommendations. The

following recommendations are based on the effective and equitable outcomes of virtual interviews

while considering the value of in-person interactions and program visibility, with Equity at the forefront,

as our primary guiding principle. Broad considerations for the full recruitment process are also offered.

Please note that guidance provided to programs from institutional DIOs and/or national subspecialty

organizations supersede these recommendations, and therefore might vary from what is outlined below.

Interview recommendations

Following many conversations and surveys with each of our organizations coupled with data from the

growing body of evidence, we strongly recommend only offering virtual interviews for the 2024-2025

recruitment cycle. Virtual interviews should be used for all applicants, including local ones, to preserve

equity. If a subspecialty differs from this recommendation, then we urge uniformity across the

subspecialty. Again, programs should follow all institutional rules set by their DIOs.

These recommendations are generated for several reasons:

(1) Effective assessment: The majority of applicants and programs highlighted that they

thought the assessment of applicants was effective using virtual interviews, and that

virtual interviewing allowed accurate assessment of programs and applicants based on

experiences after starting fellowship (Petersen TL, et al, Pediatrics 2022, Chiel L, et al,

The Journal of Pediatrics 2024).

(2) Equity: Virtual interviews are more equitable for applicants and programs, primarily in

terms of access but also financial considerations. Additionally, inequity may arise if

some institutions offer in person interviews while others do not.

(3) Cost savings: Virtual interviews save significant money for applicants and programs

(Domingo A, et al, J Grad Med Educ 2023).

(4) Minimize time away from clinical endeavors: Recognizing that our residents’ clinical

experiences continue to change, virtual interviews decrease their time away from clinical

training.

(5) Environmental impact: Virtual interviews decrease the environmental impact of

travel (Donahue, J Grad Med Educ 2021).

In-Person Second Looks

Offering in-person second looks can put undue pressure and economic burden on applicants. For the

2024-2025 application cycle, we recommend that programs do not provide program-hosted in-person

second looks.

As alternatives to program-hosted in-person visits:

1. Programs may provide information about the surrounding area. Applicants have asked for

guides/recommendations to get to know the region/city/area on their own.

2. Programs may hold virtual sessions.

3. GME/Institutions may host in-person second looks.

If subspecialty societies and institutions do allow in-person second looks, then we recommend that the

applicants not meet with program leadership during that in-person visit and that the program leadership

not be made aware of their visit. We also recommend emphasizing that attending the in-person look will

not improve the applicant’s position on the rank list (to help decrease pressure on applicants).

Additional Recommendations to Advisors of Fellowship Applicants

1. In advising applicants:

i. Be aware that ERAS has made some changes to the fellowship application in

recent years. Recent additions have included:

1. Top 10 most meaningful experiences and why

2. Geographic preferences

3. Hobbies and interests

ii. The CoPS website provides information about subspecialties at:

https://www.pedsubs.org/about-cops/subspecialty-descriptions/

1. CoPS subspecialty representatives are also available for mentorship:

https://www.pedsubs.org/membership/representatives/

iii. Learning about individual programs:

1. We encourage all applicants to review websites of programs they are

interested in.

2. In writing letters of recommendation:

a. We recommend that the Residency Program Director provide a letter of

recommendation for each applicant that addresses the following topics:

i. Clinical abilities

ii. Academic goals and accomplishments to date

iii. Leadership skills

iv. The Program Directors’ assessment of the applicant’s academic portfolio and

their long-term potential in their chosen career path

v. Please address if/how the applicant’s rotations were changed due to the COVID-

19 pandemic, viral surge, or other disruptions in education.

Commitment to continuing to study and learn what is best for pediatrics

There are many studies in progress aimed at understanding interviews and second-looks (virtual vs. in

person). We will continue to review this data as it becomes available to inform what is best for the

applicants and programs in pediatrics for subsequent years. If an institution, subspecialty or program does

something different than what is recommended here (virtual interviews for all applicants and non-program-

hosted in-person second looks), we are requesting they collect data to analyze the effectiveness of the

strategy and disseminate the results to allow us all to learn.

We will continue to share updates, innovations, and best practices with you as they arise. We are

grateful for your commitment to our applicants and developing outstanding leaders in children’s health.

References:

1. Donahue L, et al. The Carbon Footprint of Residency Interview Travel. JGME 2021.

2. Domingo A, Rdesinski RE, Cheng A, et al. Effectiveness of Virtual Residency Interviews:

Interviewer Perspectives. Fam Med. 2022 Nov;54(10):828-832. doi:

10.22454/FamMed.2022.177754. Epub 2022 Sep 14. PMID: 36350748.

3. Domingo A, Rdesinski RE, Stenson A, et al. Virtual Residency Interviews: Applicant Perceptions

Regarding Virtual Interview Effectiveness, Advantages, and Barriers. J Grad Med Educ. 2022

Apr;14(2):224-228. doi: 10.4300/JGME-D-21-00675.1. Epub 2022 Apr 14. PMID: 35463161

4. Petersen TL, King JC, Fussell JJ, et al. Benefits and Limitations of Virtual Recruitment: Perspectives

from Subspecialty Directors. Pediatrics 2022;150(4):doi:10.1542.

5. Tran AD, Heisler CA, Botros-Brey S, et al. Virtual Interviews Improve Equity and Wellbeing:

Results of a Survey of Applicants to Obstetrics and Gynecology Subspecialty Fellowships. BMC

Med Educ 2022;22(1):620.

6. Gans HA, Boyer D, Bales M, et al. National Pediatric Subspecialty Recruitment Sessions Increase

Program Visibility and Impact Candidate Application Choices, J Grad Med Educ 2023;15(3):399-

400.

7. Domingo A, Singer J, Cois A, et al. The Carbon Footprint and Cost of Virtual Residency

Interviews. J Grad Med Educ 2023;15(1):112-116.

8. Chiel L, Gans HA, Bales M et al. A Pilot Survey on Perceptions of Pediatric Subspecialty Fellows

and Program Directors on Virtual Compared with In-person Interview Experiences. The Journal

of Pediatrics 2024 DOI: 10.1016/j.jpeds.2024.114019

9. Jones RE, Abdelfattah KR. Virtual Interviews in the Era of COVID-19: A Primer for Applicants. J

Surg Educ 2020;77(4):733-734.

10. Sobolewski B, APPD Faculty and Professional Development Learning Community. Nuts and

Bolts: Virtual Interview Preparation & Coaching for Trainees. Acad Pediatr 2023;23(1):12-13.