Each year, thousands of candidates apply for residency training programs in Saudi Arabia under the umbrella of the SCFHS, which nominates some candidates to proceed with the interviews for the final matching . Every candidate will have multiple interviews in different centers of the specialty they were nominated for. The interview phase is considered challenging and crucial in the application process for the residency programs. Several elements other than the portfolio of the applicants should be considered in which every residency review committee will look for in every applicant; these elements include communication skills, attitude, reasons of interest in the specialty and center, honesty, and problem-solving skills.
In normal circumstances, in-person interviews were the only interviewing method used in the residency application process. However, over the years, this method has met some obstacles that were identified and faced in every cycle by either the residency programs or the applicants. These obstacles include that the budget for each center is considered way less than the cost of conducting the interviews each year, and most applicants who were obligated to travel to other cities to attend these interviews admit that they are time- and money-consuming due to flights, accommodation, and transportation [1,10]. In addition, they are is time-consuming for the applicants and programs as well because these interviews minimize the efficacy of the whole educational process for some time and increase the number of off days.
Furthermore, in-person interviews require a lot of effort to schedule the interviews for each day, and there are no flexibilities in times and dates of interviews for those who have scheduling conflicts between centers. Upon the start of the 2020 matching cycle and before the initiation of interviews, the COVID-19 pandemic was spreading fast, which led to the cessation of most jobs and social and personal activities. As a result, the WHO recommended implementing physical distancing measures, such as canceling all social events and gatherings and minimizing the number of employees at every workplace .
Consequently, the SCFHS released new regulations to ensure the maintenance of the residency training interview process. Videoconference interviews using different platforms were approved as the new method of running interviews, and this study demonstrated the successful implementation of such a national residency interview style. Videoconference interviews are not a new method of interviewing: some studies have compared in-person interviews with videoconference interviews in terms of financial costs, time consumption, effectiveness, and satisfaction. A study conducted in Washington, DC, USA, has shown that web-based interviews were cost-effective and timesaving for both applicants and residency programs . Another study conducted at Kaplan Joint Center, Newton, Massachusetts has found that most study participants were satisfied with videoconference interviews .
With the ever-emerging innovations and advancements in telecommunication, technology has become an evident influence in medicine. Internet applications have aided the ability to deliver appropriate, evidence-based care at vast speeds. Telemedicine has emerged as an economical means of providing care to all corners of the world. Besides, telemedicine is now being used to link major tertiary hospitals with peripheral primary care centers to provide adequate care in light of the COVID pandemic and the particular circumstances that applicants had to face and adjust to their application process and interviews . The use of telecommunication tools has brought some ease to the situation. Videoconferencing has been mandated for conducting meetings and rounds in hospitals, so the use of such videoconferencing tools was implanted concerning the applicant’s interview. In this study, before the interviews, 61.2% of the respondents noted that it was their first time to use videoconferencing tools to conduct their interview. Many devices are currently being used by medical staff to telecommunicate, including laptops, desktop computers, tablets, and handheld mobile devices. The data showed that 53.9% of the applicants used laptops for videoconferencing. Many applications are being used nowadays to communicate in business/work settings and for personal use. Zoom, Microsoft Teams, FaceTime, and Skype are among the most popular applications used during the COVID-19 pandemic . Regarding the videoconferencing electronic interface/application used by the applicants, 80.2% of the applicants used Zoom.
Although in-person interviews allow the interviewer to feel the applicant’s sense and read into their reactions more clearly, 37.3% of the applicants agreed that in-person interviews allowed them to represent who they really are accurately. Besides, in-person interviews might allow the applicants to ask more freely regarding the program from what they might notice in the environment. The use of applications might limit the questions and the timing for such inquiries. In this study, 50.6% of the applicants agreed that their questions about the residency program were answered, and 30% agreed that they felt comfortable ranking the training site based on their interview.
The financial investment needed for on-site interviews and the time spent distract from the educational pursuits and clinical responsibilities. Applicants are usually required to fund their travel and accommodation and travel requirements, adding additional financial burden to an already costly medical education. Medical residency programs allocate considerable funds to interview-day meals, tours, staffing, and others. Comparing in-person interviews with videoconference interviews, 35.7% of the applicants noted that each of them saved more than 500 SR ($133). In addition, travel and preparation time for several interviews in various locations may decrease the clinical productivity of the applicants in the interviews . In other countries, the cost is even higher, with residency applicants traveling for a median of 3 weeks and spending approximately $4,000 [1,10].
Most participants preferred videoconference interviews compared with in-person interviews; however, one of the negative sides of videoconference interviews is the lack of hostility receptions on-site that are usually conducted the night before that was often found to be important by applicants . A survey involving 400 residents in 2019 has found that 45% were stressed by their in-person interviews, which is much higher than that found in this study . Other benefits are the decreased costs; a previous evaluation of a residency program web-based interview was found to be less costly by a mean of $193 . The participants’ overall rating of the videoconference interviews was above average, and thought its organization was satisfactory, in a 2017 evaluation of videoconference interviews for fellowship programs, 85% of the candidates were satisfied .
A teleconference interview is different from an in-person interview, where each interview setting has a different level of stress that is measurable for each interviewee. In this study, most medical residents expressed that they did not have any prior experience with videoconference interviews. However, medical residents stated that videoconference interviews provided more time management than in-person interviews. They would recommend videoconference interviews to a colleague; these indications show that teleconference interviews are less stressful than in-person interviews, as more medical residents rated the event higher than an in-person interview. Johnson et al. (2019) has proposed that in-person interviews allow for more conversation; however, they do not differ significantly from other interviewing methods . Furthermore, as some remote interviews might be necessary for some situations, it will reduce the information obtained during the interview. Therefore, during a teleconference interview, the interviewee's stress level might be reduced as there is less demand for more detailed information, as they would be in an in-person interview.
Most published studies on videoconference interviews did not report factors that enhanced applicants’ experience, from a technical viewpoint, as they primarily focused on reporting its efficacy, relevance, and applicability as well as applicants’ preference and satisfaction. However, when we look to the commonly reported reasons for choosing videoconference interviews, for example, cost reduction [1-3], the use of free applications to conduct interviews would be a crucial factor in facilitating this experience, and this is by far the top perceived factor by the respondents in this study.
A recent study on videoconference interviews for surgical fellowship recruitment during the COVID-19 pandemic has reported that three of 16 applicants underwent mock interviews to facilitate their experience . Two of the three applicants (66.7%) found it helpful, whereas among the respondents of this study, 22% perceived it as helpful. Providing applicants with adequate information about this type of interview were performed in most studies reviewed and probably eased the interview flow. Furthermore, technology testing and registering software accounts ahead of time were recommended by Aparna Joshi et al. to avoid any obstacles on the event day . They also recommended hiring a technology assistant to intervene whenever needed.
Many factors have hindered the E-interviews experience for applicants; the most encountered factor was a slow or interrupted Internet connection, followed by the absence of clear instructions and the lack of previous experience in teleconferencing, whereas others faced difficulties with not receiving emails from the program directors, having issues with the application process itself.
Studies have also demonstrated the same problems, especially Internet connection issues. Both interviewers and applicants have faced Internet connection problems that resulted in low audiovisual quality. This was attributed to the fact that many applicants may not own the appropriate technology required for these interviews, and their home settings may not be suitable to hold a professional videoconference interview .
Shah et al. have suggested preventing such problems by establishing a protocol for troubleshooting in advance of the actual interview. They provided written instructions for establishing a software account a month before the videoconference interview, conducting a test call with the program coordinator to verify a successful connection during the preceding week, and offering faculty members who were unfamiliar with the technology a 5-min tutorial on the day of the interview .