The Climate Impact of Medical Residency Interview Travel in the United States and Canada: A Scoping Review

Abstract

Background The change from in-person to virtual interviews for graduate medical education (GME) provides the opportunity to compare the potential environmental effects. Objective To explore and summarize the existing literature on the potential climate impact of medical residency interview travel through a scoping review. Methods The search was conducted in October 2022 using 5 research databases. Results were screened for inclusion by 2 reviewers in a 2-tiered process. Inclusion criteria were limited to English language articles from the United States and Canada, with no limitations on the type of study, type of applicant (allopathic, osteopathic, or international medical graduate), or type of residency. A thematic analysis focusing on the objectives and main findings of identified studies was conducted and an iteratively created standardized data extraction worksheet was used such that all studies were explicitly assessed for the presence of the same themes. Results The search identified 1480 unique articles, of which 16 passed title and abstract screening and 13 were ultimately included following full-text review. There were 3 main themes identified: the carbon footprint of residency travel, stakeholders’ perspectives on virtual interviews, and advocacy for virtual interviews. All 13 articles employed persuasive language on interview reform, ranging from neutral to strongly in favor of virtual interviews based wholly or in part on environmental concerns. Conclusions Two main findings were identified: (1) Though carbon footprint estimates for in-person interviews vary, in-person interviews create considerable carbon emissions and (2) those working in GME are concerned about the climate effects of GME practices and describe them as a compelling reason to permanently adopt virtual interviewing.