Based on considerations of equity, financial impact, time, and workforce resources, all residency interviews should be conducted in a virtual format. Advances in video conferencing technology and widespread familiarity with these platforms support the use of virtual interviewing.

Virtual interviewing offers a standardized format for both applicants and programs. The efficiency offered by virtual interviews produces time savings for applicants, minimizing time away from their clinical training as well as greater flexibility in interview scheduling. Further, all virtual interviews reduce financial costs associated with the interview process for both applicants and programs.³ Data from all‐virtual GME interview experiences suggest that virtual interviews are widely acceptable to applicants, as well as program directors, allowing them to adequately learn about candidates and programs, respectively.^4-7

Residency applicants have variable financial resources and abilities to take time off from medical school and rotations. All‐virtual interviews serve to decrease inequity in these areas by offering a cost‐effective and time‐saving approach to interviews.

Residency programs should consider offering scheduling options to accommodate applicants in different time zones; institutions should offer applicants access to an appropriate interview setting, as well as reliable internet access.

Last, uniformity of approach is important for equity among applicants and programs. While no one approach may be perfect, it is important that the internal medicine community use a standardized approach to eliminate confusion for applicants and create a level playing field.

Optional in-person visits as part of the interview process can serve as a means for applicants to best evaluate their options when selecting a program, as an institution’s customs and a city’s culture will help learners determine their fit and ability to thrive. Further, program-sponsored second looks are also a tool for institutions in smaller cities to showcase both their educational offerings and their town’s aesthetics.

NRMP announced its Voluntary Rank Order List (ROL) Lock Pilot initiative. AAIM is actively participating in the pilot program, along with representatives from pediatrics and vascular surgery. Internal Medicine programs will have the opportunity to participate in the voluntary pilot this FY26. For more information on the ROL Lock Pilot initiative, click here. To note, IM programs must sign up for the pilot by September 5, 2025. IM programs participating in the program must certify and “lock” their ROLs at least 24 hours before the first post-interview visit or by February 9, 2026 at the latest.

The voluntary ROL Lock Pilot allows programs the option of securing their ROL and then allowing interviewed applicants to visit the program, confident in the knowledge that visiting (or not) will not impact their ranking on the list. Separation of program and applicant ROL deadlines will permit time for applicants to participate in optional in-person second look visits without fear of added bias, since the applicant’s visit would not influence a program’s rank order list.

Whether a program elects to take part in the NRMP ROL Pilot or not, AAIM strongly recommends that programs commit to their GME office to submit their rank lists before holding any in-person second looks. To that end, the ideal would be that programs who choose to offer open houses or second looks structure them so that applicants meet with current residents or other faculty who were not involved in developing their program's rank list. This would set applicants' minds at ease, as well as expose them to other faculty and staff who can provide additional perspective about the program.

Applicants may experience unnecessary stress while awaiting decisions regarding their interview status.^8-10 While some programs communicate interview status to all applicants at once (invitation, waitlist, or rejection), it is not the standard practice. Applicant frustrations regarding their status lead to uncertainties about how to communicate with programs, which may increase the number of communications programs receive from or on behalf of applicants.¹¹

Programs should adopt clear standards for communicating interview standings with their applicants, including anticipated dates and times of when this communication will occur. These processes should be relayed transparently to applicants and made publicly available on a program’s website. 

Implementing these standards and setting clear expectations will decrease unnecessary stress for applicants and likely decrease communication burdens on programs.  The AAIM Guidelines for Residency Interview Scheduling provides detailed guidance on applicant status communication as well as extensions of interview invitations.

Beginning with the 2025 ERAS recruitment season, the ERAS Interview Scheduler tool will be discontinued.  Programs are encouraged to use Thalamus Core, a complimentary product within the Thalamus suite that serves as an interview management tool with direct ERAS interface. The platform offers interview scheduling functionality and the ability for programs to rank and score interview candidates. Further, Thalamus Core includes a functionality that would assist residency programs communicate an applicant’s interview status.  Having interview and other outcomes data from Thalamus Core helps AAMC provide the Internal Medicine community with stronger analytical information about signal and interview data at the conclusion of the recruitment season.

Standardized letters of recommendation improve a reviewer’s ability to meaningfully review applicants’ characteristics and are more efficient for writers and reviewers alike. In 2021, AAIM published guidelines for structured evaluative letters, which were updated in 2022 to include FAQs for IMGs and clarification on COMAT interpretation.¹² These guidelines allow medical schools to advocate for their learners by communicating the applicant’s cognitive and non-cognitive capabilities. The SEL summarizes the information and data that residency programs need to holistically evaluate applicants and should replace previous Chair letters.

Multiple groups of individuals face systemic bias and barriers in the residency interview process, and programs may encounter challenges demonstrating their inclusion towards these groups. Further, bias can permeate the interview process at both the individual and systemic levels, negatively impacting both applicants and residency programs.

In fall 2022, AAIM released recommendations on how to integrate equity and inclusion into the residency interview process.¹³ Because implementation will be challenging for any program, the recommendations provide a roadmap on how to prioritize strategies. AAIM recommends that programs first conduct a needs assessment to determine which recommendations are easily or immediately implementable, then decide which ones could be adopted in the future.

Medical schools should provide students with resources to help them prepare for and participate in virtual interviews.^14-15 These resources should include preparation education, reasonable time away from clinical rotations, and technical support. Specifically, medical schools should work with their institutions to provide applicants access to a private and appropriate interview location, as well as technology with video conferencing capabilities, and reliable internet access. Institutional provision of these resources mitigates the potential for technology bias that may exist when applicants have different technology or financial resources.

Because international medical graduate (IMG) applicants may be disadvantaged without these medical school resources, those applicants who are working or affiliated with institutions in the United States ideally should have access to the same institutional resources. Additional collaboration and research are needed with IMG special interest groups, such as the American Medical Association (AMA), Intealth, AAMC, or the American College of Physicians (ACP), to assist applicants and secure equivalent resources for applicants not currently affiliated with a US medical school.

Problematic communications have been reported during and after residency interviews. Without appropriate training, interviewing faculty may inadvertently violate match agreements by inquiring into topics such as rank order lists, interview locations, or geographic preferences.

Additionally, post‐interview communication has the potential to create confusion and stress for applicants, particularly when coercive or disingenuous.

As such, AAIM strongly discourages programs from sending tailored, individualized post-interview communication. If post-interview communication is necessary, establishing guardrails are imperative. Below are some recommendations:  

• Programs who wish to send updates or any “program-initiated informational outreach or post-interview events” should share these with all candidates, regardless of their background, standing, or track interest. Overall, programs are strongly encouraged to message all applicants or all candidates within a specific group, rather than individuals.
• Programs should articulate that interviewees refrain from sending “thank you” notes. Rather, programs should state that applicants are welcome to ask clarifying questions about the program. Residency programs can also indicate that they are willing to share additional information pertaining to their program at the candidate’s request. Faculty and staff should emphasize that they are prohibited from communicating the candidate’s odds of ranking or matching to their program.

In summary, adherence to the NRMP Match Code of Conduct for Programs (PDF) concerning post-interview communication is critical:

Program directors and other recruitment team members must ensure all information related to the program’s mission, aims and eligibility are clearly communicated to applicants. However, applicants may not have adequate time to obtain the information needed to make informed decisions about ranking and may wish to clarify information following interviews. The recruitment team may exchange clarifying information with applicants following the interview, but must not solicit or require post-interview communication for the purposes of influencing applicants’ ranking preferences. Program directors and all members of the recruitment team should take great care not to promote misleading communication to applicants about ranking intentions and preferences or inappropriately share private information (e.g., letters of recommendation) with outside parties.

In addition to the above, programs should develop a succinct statement about their program’s policies on communication with applicants. This statement should clearly indicate the following: 

• Adherence to the NRMP Match Agreement and Code of Conduct.  
• Indicate that annual training does take place.
• Share where applicants can find a program’s policies. 

Residency programs should require annual faculty and staff training on appropriate interview and post‐interview communication to minimize inappropriate communication.¹⁶ Below are a few suggestions on what should be covered in the training:

• Describe the range of benefits of adherence for the program and individuals.  
• Articulate the range of negative consequences of non-adherence for programs and individuals. If possible, provide data on occurrence and examples of inappropriate communication.  
• Provide samples of appropriate questions. It is advisable to conduct role-playing or scenario-based instruction.  
• Review practices to mitigate differences in communication based on explicit and implicit biases.

Further, residency programs should share resources with applicants on how to respond to inappropriate communication should it occur. Finally, faculty involved in interviewing applicants should receive training on unconscious bias that may arise during the interview process.¹⁷