Appendix 4 Included Studies BEME Virtual Interviews in Graduate Medical Education

<strong>Abstract:</strong> <strong>Background</strong> The COVID-19 pandemic caused graduate medical education (GME) programs to pivot to virtual interviews (VIs) for recruitment and selection. This systematic review synthesizes the rapidly expanding evidence base on VIs, providing insights into preferred formats, strengths and weaknesses. <strong>Methods</strong> PubMed/MEDLINE, Scopus, ERIC, PsycINFO, MedEdPublish and Google Scholar were searched from 2012 to February 21, 2022. Two authors independently screened titles, abstracts, full texts, performed data extraction and assessed risk of bias using the Medical Education Research Quality Instrument. Findings were reported according to Best Evidence in Medical Education guidance. <strong>Results</strong> One hundred ten studies were included. The majority (97%) were from North America. Fourteen were conducted before COVID-19 and 96 during the pandemic. Studies involved both medical students applying to residencies (61%) and residents applying to fellowships (39%). Procedural specialties were more represented than non-procedural specialties. Applicants preferred VI days that lasted 4-6 hours, with 3-5 interviews lasting 15-20 minutes each, with virtual tours and opportunities to connect with current faculty and trainees. Satisfaction with VIs was high, though both applicants and programs found VIs inferior to in-person interviews for assessing fit. Confidence in ranking applicants and programs was decreased. The distribution of match outcomes shifted, with home match rates increasing in some specialties, decreasing geographic diversity. Stakeholders universally noted significant cost and time savings with VIs, as well as equity gains and reduced carbon footprint due to eliminating travel. The optimal future state remains unclear, though a hybrid model (e.g., VIs followed by a limited number of in-person second looks) may optimize strengths and weaknesses. <strong>Conclusions</strong> The use of VIs for GME recruitment and selection has accelerated rapidly. The findings of this review offer early insights into preferred formats for VIs, as well as strengths and weaknesses that can guide future practice, policy and research.