George, a fourth year medical student was all set for his online interview on Thursday afternoon. Him and his housemates, all in the same cohort, were doing the final preparations, their computers were ready to go and their celebratory dinner reservations set. 

But then around 5pm confusion and panic started to set in, as email logins were delayed and students on social media were posting about technical disruptions. 

“We started to see comments just flooding, that people couldn’t get past that bandwidth testing stage, despite having good enough internet two days before during their testing,” George said. 

Victorian internship applications work a little differently to other states. They include in-person interviews, a CV and a cover letter, as well as an aggregate score from your academic record known as a Z score. The application process is coordinated by a central body, The Postgraduate Medical Council of Victoria, (PMCV) but the hospitals give different weight to the various elements of the application, depending on their preference. Students also take these preferences — though they aren’t always made public — into consideration when they make their applications to a particular hospital. 

This year, because of coronavirus restrictions, things changed. PMCV suggested hospitals follow the weighing system as follows: 40% allocated for your interview, 40% for your Z score and 20% for your CV and cover letter. Interviews were also replaced by a video recorded by students based on the same set of 5 questions. They had one minute to read the prompt and four minutes to respond to each question. 

Students had been given the opportunity to test the functionality in the week leading up to the exam, but when things started to fail on Thursday evening they were left unprepared.  

“PMCV had always said that, if things were going to go wrong, we have backup plans. We have contingencies. But they didn't tell us what the contingencies were,” said George. 

This sent medical students into a panic with student representatives from the Medical Student Council of Victoria fielding students’ questions to PMCV and then feeding responses back again through facebook groups. 

“Of course we're sitting there refreshing the page, waiting to see what problems people are having [before we record ours],” George added. “Some people got through, but then during the recording, their file got corrupted or it didn't save properly. Some people got all five done and then the upload failed.” 

Not all students had issues, however. Another fourth year student from a Melbourne university, Nick, successfully recorded his interview responses. But he was confused by what he said were mixed messages coming from PMCV. 

“They [PMCV] actually emailed everyone saying that everyone has to do it again the next day. I was really disappointed because I put all this effort into my interview and I thought it was over. But then I had to experience it again, another day of all that stress, I wasn't happy.”

According to a statement on PMCV’s website, “At the time of our first communication, it was believed that it was a wide scale Telstra network outage of which we had no control over to address. This is why we advised a new interview time block would be offered on Friday with new questions,” the statement read. 

“In the following hour, we noticed that the number of completed interviews rose substantially very quickly. This led to our next communication to advise that the Friday interview was an opt in, if you experienced technical glitches during your first interview.”

According to PMCV students will be provided with a doodle poll on Tuesday, where candidates who had two attempts at the interviews can nominate their preferred video. PMCV wrote on their website that, “we are hopeful that only one video will be provided to the Health Services that you have selected.”

But in a statement to MedicGuild, PMCV confirmed that, “health services will only have access to the chosen videos.”

There were also questions around whether this technical glitch will change the weighting of the interviews. Representatives from the Medical Student Council of Victoria (MSCV) took a poll from students via facebook groups, with mixed responses from across the universities. Students expressed their frustration with not just the technical problems, but also the various changes, the inequity of some people having a second chance to record their video, as well as allegations of leaked questions. The MSCV have been in communication with PMCV, to discuss this issue and others, but MSCV told MedicGuild that, “the Council is unfortunately unable to provide further comment at this time”.

PMCV told MedicGuild in a statement on Tuesday that, “the weighting will remain at 40% as we will give students the option to select which video they prefer the Health Services to view and assess.”

But the stress experienced by students in this past week has also raised questions around the internship application process in general, with some calling for the state to adopt a ballot system like the rest of Australia, instead of individual hospitals setting their own admission standards. 

 “It's not meritocratic,” George said in response to the current system.

George also said that to differentiate scores, and create a competitive field, a number of niche questions that go beyond the scope of what a junior doctor does creates an unnecessary amount of pressure in their final years.  

“At the end of the day, we're trying to create a safe junior doctor. That's the purpose of medical school, not to create a specialist, not to create a consultant, just to create a safe junior doctor. So, as long as we have the basic education and we can pass our basic assessments, and have the practical skills and the ability to do the job. That's what the role of medical school is.” 

For Harry Copeland, a fourth year medical student at the University of Queensland, a ballot system relieves a lot of the pressure in their final year and in their intern year. 

“In many ways intern year can be seen as an additional year of medical school - a lot of support and some assessment,” Copeland said. “It’s better to have the opportunity to develop collaboratively than competitively. I believe that studies show interns are essentially all as competent when they finish the year, so it doesn’t really make sense to penalise people for not scoring well two or three years earlier.” 

For Dr. Thomas Kelly, an HMO at the Alfred Hospital, the ballot system has its pros and cons. 

“It will reduce the amount of stress that medical students have,” Dr. Kelly said. “But, I think the problem with a ballot system is that subsequent jobs, in your second and third postgraduate years, will look at which hospital you did your internship at, look at the references that you've received and then grade your application based on this.” 

“If you're a student or a doctor looking at a particular specialty, let's say neurosurgery, you'll only get exposed to neurosurgery if you work in certain hospitals in Victoria. So in this case a random ballot system could disadvantage you.”

But Dr. Kelly also believes that students will have to use their medical school grades for hospitals to be able to differentiate candidates when applying for second and third year roles, if a ballot system were used for their intern year. However, he also reiterates that even if assessment is stressful, marks aren’t the only way to measure your performance, knowledge and drive.  

“There are other ways to improve your chances in specialty training, by reaching out to doctors that are working at the hospital that you are interested in and offering your time to do research or shadow the doctors during theater or on ward rounds,” Dr. Kelly said. 

“But medical school is stressful and so is the workforce. I think a better way to manage that is to build on what universities are doing in terms of a holistic approach to supporting the mental health of their students.”

** some names of students have been changed to protect their anonymity