A chance for reform: the environmental impact of travel for general surgery residency interviews

Abstract

Background: In light of the global climate emergency, it is worth reconsidering the current practice of medical students traveling to interview for residency positions. We sought to estimate carbon dioxide (CO₂) emissions associated with travel for general surgery residency interviews in Canada, and the potential avoided emissions if interviews were restructured.

Methods: An 8-item survey was constructed to collect data on cities visited, travel modalities, and costs incurred. Applicants to the University of Ottawa General Surgery Program during the 2019/20 Canadian Resident Matching Service (CaRMS) cycle were invited to complete the survey.  Potential reductions in CO₂ emissions were modeled using a regionalized interview process with either one or two cities.

Results: Of a total of 56 applicants, 39 (70%) completed the survey. Applicants on average visited 10 cities with a mean total cost of $4,866 (95% CI=3,995-5,737) per applicant. Mean CO2 emissions were 1.82 (95% CI=1.50-2.14) tonnes per applicant, and the total CO2 emissions by applicants was estimated to be 101.9 (95% CI=84.0 – 119.8) tonnes. In models wherein interviews are regionalized to one or two cities, emissions would be 57.9 tonnes (43.2% reduction) and 84.2 tonnes (17.4% reduction), respectively. Overall, 74.4% of respondents were concerned about the environmental impact of travel and 46% would prefer to interview by videoconference.

Conclusion: Travel for general surgery residency interviews in Canada is associated with a considerable environmental impact. These findings are likely generalizable to other residency programs. Given the global climate crisis, the CaRMS application process must consider alternative structures.