key: cord-0053557-xpw6qnxo
authors: Goldman, Joshua J.; Zhitny, Vladislav Pavlovich; Iftekhar, Noama; Teven, Chad M.; Baynosa, Richard
title: Can the Augmented Web-based Applicant Experience Replace an Audition Rotation?
date: 2020-10-28
journal: Plast Reconstr Surg Glob Open
DOI: 10.1097/gox.0000000000003189
sha: 93770f5ffa79d9dcaa33c2b939dec6b5c041089e
doc_id: 53557
cord_uid: xpw6qnxo

nan

A recently published study estimated that 67% of students rotated at their matched plastic surgery institution, up from nearly 50% before. [1] [2] [3] [4] Program Directors rank the away rotation highly (often number 1) among tools for choosing trainees, [1] [2] [3] [4] and applicants feel that the rotation makes them more competitive. 2 The COVID-19 pandemic has drastically altered medical education and will continue to affect training and the process of choosing trainees. As a precaution, the American Council of Academic Plastic Surgeons (ACAPS) suspended visiting student rotations this year, except for students lacking a home program. 5 In response, several programs have launched virtual subinternships. These Augmented Web-based Applicant Experiences (or AWAE rotations) entail personal meetings with program directors and faculty, resident hangouts, virtual tours, skills workshops, grand rounds, and other creative adjuncts. While little doubt exists that educational content can be provided virtually, the question remains as to the preservation of the audition aspect of such rotations. Given the away rotation's weight in choosing trainees and in building applicant rank lists, it is paramount to consider the benefits of AWAE rotations, for programs and applicants, as well as ongoing challenges.

The ACAPS standardized letter of recommendation incudes "Qualifications for Plastic Surgery." Some qualities can be assessed virtually to a degree (communication skills, academic skills, professionalism, technical ability), while others are more difficult (team player, patient care, research and teaching, work ethic). Despite added convenience to the applicant, one would be hard-pressed to argue any of these categories are better assessed virtually, and the necessary technological resources may be prohibitive to some programs (Table 1) .

For applicants, the AWAE provides an invaluable learning opportunity, but only limited insight into the complex dynamics of a program ( Table 2 ). As such, program websites, Doximity rankings, and student reviews from Reddit may more strongly influence applicants' rank list going forward. The culture of the program and personality of the applicant may remain elusive with sole reliance on web-based information and virtual encounter. An inperson rotation ostensibly offers deeper awareness of program and applicant fit, less biased by manufacture, though elucidation of this concept will require further study.

From the applicant and program standpoint, the AWAE rotation is like shopping for clothes online, complete with virtual fitting and customer reviews…but from a store with a strict "no exchanges, no returns" policy. Additionally, the Step I's change to Pass-Fail, may encourage further weighting of direct interaction. Assuming this shift represents the new normal, rather than a temporary change, AWAE rotations provide new methods of subjective and objective evaluation. They are a cost-effective and convenient means of providing a glimpse of the program for the applicant and vice versa. Still, significant disparities between the virtual and in-person experience must be recognized, measured, and assessed longitudinally, and further innovation will be required to diminish or circumvent gaps in culture and personality assessment if residencies are to meet the longstanding objective of choosing the best individuals for each program.

The plastic surgery match: predicting success and improving the process

Away rotations and matching in integrated plastic surgery residency: applicant and program director perspectives

Swings and roundabouts: paradoxes of the away rotation

Away rotations in plastic and reconstructive surgery: a survey of program directors

Association of American Medical Colleges. Specialty Response to COVID-19

The authors have no financial interest to declare in the relation to the content of this article.