#KeyLIMEPodcast 310: Time to put a travel ban on residency interviews

It is no secret that the residency application process places a significant financial and time burden on learners. Lara presents an article that looks article examines the additional strain it puts on our planet. Using a survey of 4th year medical students from a single institution, the authors set out to determine the carbon footprint associated with travel to residency interviews.

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KeyLIME Session 310

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Donahue et.al. The Carbon Footprint of Residency Interview Travel J Grad Med Educ 2021 13(1):89-94.


Lara Varpio (@LaraVarpio)


  • Residency application processes place a significant financial and time burden on learners.
  • These authors suggest that there is an additional burden that the residency application process demands — but this one is on our planet.
  • These authors set out to find out just how significant a toll that travel places on our environment


  • To determine the carbon footprint associated with travel to residency interviews of the applicants from a single institution.

Key Points on the Methods

  • Survey of fourth year medical students about the travel they did for their residency interviews, specifically: their specialty, the number of interviews completed, the start and end points for every flight, train, bus or car trips. And for the cars, they asked about the make, model and year of the car.
  • The survey was reviewed by an education faculty member and a content expert, and was piloted with a small group of medical students for feedback
  • Survey was sent to the graduating 4th year students at one medical school
  • Descriptive statistical analyses for specialty and number of interviews
  • They calculated the carbon footprint for each and every trip using different calculators available on line, calculators that are audited and vetted by different government bodies. And they did a verification of their calculation with different calculators. And they did take into consideration the average capacity of each mode of transportation — so the carbon footprint of a flight was divided across the average number of travelers on each flight.

Key Outcomes

  • Response rate = 59%
  • The average number of interviews per applicant varied widely —3 to 45 interviews.
  • The class average was just over 14 interviews per student. There was no statistical difference across specialties in terms of the number of interviews attendant
  • 55% of these interviews required air travel, 40% were car trips and 5% were train trips
  • The total carbon footprint per student was calculated at over 3 metric tons of CO2
  • Well, the authors extended their results to all the US seniors who participated in the 2019 match. They calculated that if all those learners did NOT travel for residency interviews, it would be equivalent to getting 11,162 cars off the road for an entire year.
  • Limitations: The study was conducted at one school. Limited number of participants they had in different specialties. Both limit generalizability.

Key Conclusions

  • Medical education leaders could help reduce the carbon footprint by encouraging a reduction or even the end of in-person interviews.

Spare Keys – other take home points for clinician educators

  • Great example of the kind of scope of project that makes a great learner research project. The paper isn’t complicated. The question isn’t too massive. It is a nice, small-scope study with a simple, straightforward and powerful research design.

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