The AAMC on Interview Hoarding

The AAMC recently released an open letter sounding the alarm bells on how the residency interview season is shaping up this year:

We are seeing students in the highest tier receiving a larger number of interviews per person than in past years, leaving other students – including those in the middle of the class – with fewer interviews than we would anticipate based on their qualifications.

Interestingly, interview software purveyor Thalamus is arguing that this year is like last year. Who is right? I don’t know. Perhaps the AAMC’s data tells a different story. Or maybe they’re crying wolf. They do have a vested interest in programs filling and people matching at high rates to stave off growing criticism of their growing ERAS revenues.

They go with this advice to schools:

Discuss any additional steps that students with fewer interview offers than anticipated might take at this point to maximize their likelihood of matching (for example, applying to preliminary positions for which applications are still being accepted).

This could also read: we recommend people give us more money by applying to more programs.

Also, this is terrible advice. There’s a good chance there will be more spots in the SOAP than usual this year. If you’re a typical applicant who would expect to match in years past but are suffering from a dearth of interviews, why would you pass up the chance for a categorical spot in the SOAP for a prelim position that goes nowhere? The kinds of prelims that are accepting new applications in December are probably the kinds of spots that aren’t selling like hotcakes pre-SOAP anyway.

And they offered the following advice for students:

Consider releasing some interviews if you are holding more than needed, allowing your fellow students access to these interview opportunities. If you have fewer interview offers than anticipated, discuss with your student affairs officer or advisor any additional steps you might take at this point to maximize your likelihood of matching (for example, applying to preliminary positions for which applications are still being accepted).

People have largely been going on too many interviews (for years). While some fields have a preponderance of tiny programs, nearly 80% of successful applicants will end up with one of their top 4 and rarely go beyond 7-8.

However, it’s ludicrous to put this back in the students’ hands and argue that they should go against their own interests. Overapplication and–to some extent–interview hoarding are rational choices made to maximize the odds of a successful match. We shouldn’t blame students for playing a poorly designed game as best they can.

The AAMC has the most power to improve this process

This year should serve as a wake-up call because it’s not the n=1 powerless students that have the agency here. It’s the AAMC. The combination of pass/fail Step 1 and increasing graduating medical student numbers was already threatening to send the residency selection process into an application fever death-spiral before the pandemic, and they’re still coming for us.

Though, sure, look at Charting Outcomes and your interview plans. If you’ve been on a bunch of interviews and you have some programs lined up that you aren’t genuinely interested in, you could potentially change a peer’s career by giving up a slot in addition to avoiding another day on Zoom.

But the real take-home point is this:

The AAMC, through its highly-profitable administration of ERAS, is ultimately the entity responsible for the “maldistribution of residency interview invitations.”

The rest of us are just doing the best we can.

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