The General Surgery Residency Applicant Perspective on Virtual Interviews Pre and Post Vaccine Availability

Introduction: With two cycles of virtual residency interviews, we evaluated applicants' perceptions and behavior. Method(s): All 2021 and 2022 general surgery interviewees at our institution were surveyed. Analyses were conducted using chi-square and t-tests. Result(s): Cumulatively, 134 of 238 interviewees responded (56.3%). Respondents were 50.3% male, 83% white, and 27.2 years old (SD 2.9). Candidates applied to more programs due to interviews being virtual (61%), but this effect decreased in 2022 (38%, p=0.2). Similarly, they endorsed accepting more interviews (54% in 2021 and 45% in 2022, p=0.6) with a median of 17 interviews in 2021 and 15 in 2022 (p=0.18). 27.6% reported expanding their geographic reach. The advantages were consistently saving money (96%), saving time (50%), and avoiding COVID-19 (44%). Top limitations were the inability to observe interpersonal interactions (61.2%), increased difficulty comparing programs (58.2%) and less exposure to current residents and faculty (57.4%). In the 2022 cycle, 84.7% of candidates felt the common supplemental application was not worth their time because it did not improve their application. 95% of respondents 'signaled' their top five programs, from which 20% received no interview offers and only 3% received offers from all. Conclusion(s): Virtual interviews led applicants to expand their geographic range and increase the number of programs to which they applied;however, 2022 saw a dampening of this effect. Perceived limitations did not improve in 2022, and the supplemental application was not valued by applicants. The benefits of virtual interviews must be balanced against the intangible ability to observe program culture.

An Internal Clinical Deterioration Report and Care Process: A Quality Improvement Project

During the early stages of the COVID-19 pandemic, providers initially based treatment decisions upon established guidelines for adult respiratory distress syndrome. Even though emergency intubation and mechanical ventilation were recommended for first-line treatment of critically ill patients, clinical leaders in one New Jersey hospital observed mortality rates increased sharply for patients with COVID-19 receiving mechanical ventilation, particularly among the elderly. An interprofessional team created a Deterioration Report, which aggregated key laboratory, radiologic, and other clinical biomarkers. A follow-up provider satisfaction survey indicated treatment decisions were positively influenced by the Deterioration Report, to the extent at-risk patients were identified rapidly and accurately, placed on high-flow oxygenation as first-line treatment, and successfully avoided intubation in most cases. © 2021, Anthony J. Jannetti Inc.. All rights reserved.

Characterizing Covid Waves via Spatio-Temporal Decomposition

In this paper we develop a framework for analyzing patterns of a disease or pandemic such as Covid. Given a dataset which records information about the spread of a disease over a set of locations, we consider the problem of identifying both the disease's intrinsic waves (temporal patterns) and their respective spatial epicenters. To do so we introduce a new method of spatio-temporal decomposition which we call diffusion NMF (D-NMF). Building upon classic matrix factorization methods, D-NMF takes into consideration a spatial structuring of locations (features) in the data and supports the idea that locations which are spatially close are more likely to experience the same set of waves. To illustrate the use of D-NMF, we analyze Covid case data at various spatial granularities. Our results demonstrate that D-NMF is very useful in separating the waves of an epidemic and identifying a few centers for each wave. © 2022 ACM.

The General Surgery Residency Applicant Perspective: Virtual Interviews Limit Current Resident and Faculty Exposure, But Save Money

Introduction: The COVID-19 pandemic required applicants to adapt an entirely virtual interview platform. We sought to evaluate the impact on applicant perception during the 2021 Match. Methods: A voluntary, anonymous survey with 5-point Likert scale and free text was sent to our general surgery interview applicants (Fig. 1). Data including demographics were analyzed using chi-square and paired t-tests. Results: Surveys were completed by 75 of 108 (64.9%) interviewees. Mean (SD) age was 26.9 (2.11) years, 53.3% were male, 77.3% were non-Hispanic White, and 19.9% were an underrepresented minority. Disproportionately fewer female and underrepresented minority applicants completed the survey. Applicants accepted a median of 17 interviews (range 2 to 40). Sixty percent (n = 45) applied to more programs and 52% (n = 39) accepted more interviews because they were virtual;only 25.3% (n = 19) applied to more diverse geographic locations. Perceived advantages include saving money (96%), saving time (45.3%), and avoiding COVID-19 transmission risks (42.7%). Top limitations include the inability to observe the interactions between faculty, residents, and staff (61.3%), difficulty comparing programs (57.3%), and less exposure to current residents and faculty (57.3%). Despite demographic differences, interviewees were generally in agreement with no statistically significant differences in responses. Conclusion: The sudden shift to virtual interviews presented unique challenges and opportunities. The inability to observe interactions and meet in person with future attendings and residents was a significant dissatisfier. Beyond COVID-19, efforts to reduce interview costs and increase accessibility will need to be balanced against the intangible benefit of human interaction and observing a program’s culture. [Formula presented]