Unmasking the Environmental Costs of In-Person General Surgery Residency Interviews

Objective: As COVID-19 restrictions are eased, there has been a lively debate on whether residency recruitment interviews should be held virtually or in-person. However, environmental impact has rarely been a focus of this debate and only by inference from limited survey data. In this study, we aimed to estimate the carbon emissions generated from air-travel versus in-person interviews in the general surgery residency recruitment.

Design, setting, and participants: This was a cross-sectional study using interview data from the 2022-2023 surgical residency recruitment season from the Thalamus (SJ Medconnect, Inc. Santa Clara, CA) data warehouse. We located applicants' closest airport and the airport nearest each program with which they interviewed. Following the Greenhouse Gas Protocol's definitions, we then estimated carbon emissions as a specific component of scope 3: travel of the greenhouse gas inventory.

Results: We analyzed 5989 completed interviews occurring between 2369 applicants and 65 programs during the 2022-2023 recruitment season. Of these, 4529 (75.6%) required travel of 150 miles or more, meeting our inclusion criteria for carbon emissions estimation. The mean number of interviews per program was 95.4. Median number of flights per recruited position was 10. The estimated total carbon dioxide emissions for the interview season were 3502.04 tons. These emissions are the equivalent of 3.9 million pounds of coal burned or 441 homes' energy use for 1 year.

Conclusions: There would be a significant environmental impact from air travel alone if general surgery interviews were to revert to an in-person format. These findings should be considered -alongside cost, equity, and goodness of fit- when making specialty- and program-level decisions regarding interviewing modalities.