Interviewing for residency

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2] Sudarshana Datta, MD [3]

“A good interview can save someone with the less than perfect application. A bad interview cannot always be salvaged by a paper record.”

Understanding the 'why' behind the interview process

Before one begins preparing for the interview, it is important to understand the ‘why’ behind the interview process. An interview is really not as intimidating as one makes it out to be. Candidates have been called for the interview because the program is interested in them, and the interview process is meant to determine if they are the ‘right fit’ for THAT particular program. Understanding the purpose of the interview is very important. If a residency program already has access to your CV and has your letters of recommendation that speak of your clinical acumen and good character, understanding the reason why they would like you to travel all the way to come and meet them is extremely important. There are two questions that every program seeks an answer to whilst interviewing a candidate:

1)Can they work with this person on a daily basis?

2)Why would this candidate specifically rank their program over and above every other program?

The entire discussion that one has during the interview is actually geared towards answering these two questions. For the first part, the interviewer wants to determine how you are as a person. The candidate should be personable and should understand that he/she is ‘part of a whole’. He/she should be able to get along with the rest of the team and should care for his/her patients. It is important for the candidate to understand that as a resident, he/she is going to be a part of a larger picture. Residents work with the house staff, pharmacists, physiotherapists, faculty from different departments, hospitalists and all of have a crucial role to play in the process of patient management. As one of the program directors rightly said, “If you don’t have the medical knowledge, we can teach you that. We, however, cannot teach you how to not be a jerk.”
Every program you visit will ask you ‘why specifically us’? If you are going on interviews to different places, what is something that is so specific about their program that would make you want to stay there for the next three years of your life? Is there something specific about the city/location that draws you there? Any family ties? Prior experience in the same program? This is really the most important question that any interviewer will ever ask you and it gives them a clear picture of how keen/excited you are, to be interviewing with them. They’re looking to see your interest, how much you know about the program, what you want to know (asking questions is extremely important). It’s always good to ask a lot of questions and let the interviewer speak. It's human nature to like people who ask us questions about ourselves and listen to what we have to say to them. It is important to remember that the person sitting before you knows many things you don’t and that there is a lot to learn simply by listening. LISTENING is very important, as that too, is a reflection of your interest! In fact, letting the interviewer speak is a crucial part of the interview process. All the people interviewing you have several years of wisdom in their respective fields that they would love to impart, and it is great to give them the opportunity to do so!
After understanding the 'why' behind the interview process, one must begin preparing for the interview. Preparation and presentation are key factors in acing a residency interview. Strong preparation also helps in avoiding nervousness on the day of the interview. There are methods in which one can prepare for the interview, and avoid the pitfalls which may leave a negative impression. The impression that one can leave can be impacted by appearance, attitude, behavior, answers to interview questions, and the questions that are asked of the interviewer. Not preparing for interview questions and planning to "speak from the heart" is not the best way to interview. You can speak from the heart, but you should know what you are going to say, and know how to convey it effectively and concisely.

Take-home lessons from the interview trail

The interview actually begins from the time you get a call from the program. One must be quick and polite while responding to emails and strive to establish a rapport with the program coordinator.
If you have some time before the interview, especially in a city you have not been to before, this is the perfect opportunity to explore! There’s a possibility you may never visit that particular place again, so make use of your only chance! More importantly, sampling the places you interview in helps familiarize you with the city and plays a major role when you are ranking programs. Being comfortable with the city that you’re interviewing in is important, especially if you wish to rank that program amongst your top choices. It is advisable to visit as many places as you can and sampling the food in that area is always great, especially if you are fastidious in your food preferences!
Prior rotations/ experience in the program that you are interviewing in definitely confers an advantage. It enables you to be familiar with the program, its workings, opportunities and residents. The interview experience can be very different if one is already familiar with the city, the program and its residents. You will be more relaxed and are more likely to make a good impression. It also enhances your chances of matching into that program.
Never be late for your interview. If time permits you to do so, go a day prior and check the place where you will be interviewed so no time is wasted on the interview day and your chances of running late are negligible.
The matter of post interview correspondence is typically a grey area. While some programs completely prohibit it, other programs welcome post interview communication. Whether the program you are interviewing in is the former or the latter category may be determined on the interview day. Most programs make their stand very clear on their preferences and sound them clearly to the candidates. A simple rule to follow would be that there is no harm in engaging in post interview communication unless a program explicitly refutes it.
If the program welcomes post interview communication, email the program director, the coordinator and the faculty you interviewed with, thanking them for inviting you to their program. It is advisable to not send a generic thank you email to all the programs you are interviewing in, although you may be tempted to do so, if you have a tight schedule of successive interviews. It is always better to tailor your emails to the people, referring to the conversations you had with them and what you gained from your experience in that program and after your communication with them.
Pre interview dinner advice: There is a very simple tip to nailing the pre interview dinner. And that is simply that you must show up for it! Most programs only check attendance, as that is a clear reflection of a candidate’s interest in that program. Be open and friendly when talking to the residents. Ask as many questions as you possibly can. The pre-interview dinner provides you the perfect opportunity to gather ample information about the program. This can help you answer the ‘why specifically us’ question that every interviewer will have for you the next day. Try to make that answer as sound as possible by gathering as much information as you can, from your interaction with the residents. The pre interview dinner can give you a clear picture of the program structure, allows you to gauge the satisfaction of the residents, palpate the sense of camaraderie, and learn about fellowship opportunities, research support, and the diversity within the program. It’s a nice way to get a slice of the life of the residents, and have all your questions answered without any judgement. Talk to the other candidates. Be at ease with the residents and other candidates. The purpose of all the interview dinners is not only to learn about the program, it’s also a life lesson in grooming and honing your social skills. Enjoy it. However, not paying attention, constant texting and unwillingness to mingle with others are noteworthy red flags, so kindly refrain from these activities.
Never miss the program tour and make it a point to ask a lot of questions on the tour. Attending the tour is a reflection of your interest and your presence or absence during the tour is keenly noted.
Organize your thoughts and your answers to questions. Adequate practice prior to the interview ensures that you are not disorganized in your answers and in your presentation of yourself.
Compliment the interviewer about the program. There are times when candidates are so caught up with projecting themselves and their application that this aspect may get side-lined. Also, ask your interviewer lots of questions. Some universal things that all program directors love to be asked include questions on their experience in the program, the qualities they are looking for in their residents and their advice on internship and residency.
What you write under the section of hobbies and interests and your personal statement is probably the most important topic of discussion all through your interview trail. Make sure you own what you’ve written down as they can lead to some of the most fascinating and memorable conversations that you will have with your interviewers. Sometimes interviews begin and end with a line from your personal statement or a common hobby that you may share with the interviewer.
Always tailor your answers to the program. Different programs pride themselves in different things. Some hospitals focus primarily on patient care, while other institutions lay equal emphasis on both research and clinical medicine. It is good to research the program you will be interviewing in as your knowledge about them is a reflection of your interest. It also enables you to know exactly what the interviewer wishes to hear.
Some of the relatively uncomfortable questions that you may be asked include your weaknesses, marital status, number and location of other interviews and justification for a gap year(s). When asked about a weakness, acknowledge an actual weakness/character flaw and the steps you may have taken towards mitigation and management. If you have a gap year from clinical medicine, speak clearly about what you have done and how that has helped your application. Always end these answers on a positive note.
There are some programs that offer candidates the opportunity of staying with the residents prior to the interview. It’s always a good idea to pick that option as it helps you learn more about the program. Some programs pride themselves in the accommodation they offer to their residents and it gives them a great deal of joy to learn that you have sampled it.
Advice on ranking programs: Picking a residency program is like picking your family for the next three years. At the end of the day, you must choose the program that not only looks out for your interests, but also a place that makes you feel comfortable, respected and valued. Pick the program that will get you where you want to go. Barring the ranking of the program and the opportunities it offers, an equal weightage should be given to how you felt on the day of the interview. This decision should be carefully made as the next three years are crucial, both in terms of your training and personal development.
The biggest lesson is not to take the interview process too seriously, as that makes the entire endeavour seem gigantic and harrowing, which it isn’t supposed to be. Although it is easier said than done, try and enjoy the entire process instead of being bogged down by it.

Steps to Prepare for the Interview

1. Read and know all the information on the program website. Prepare questions based on some of the information that is on the website. Don’t ask questions that have the answer on the website.

2. Research the main achievements and goals of the program and the faculty. You are trying to show that you would be a good fit for their program, so if they are highly involved in academics, you will want to highlight your past and future contributions towards academics during the interview.

3. If you know who you will be interviewing with, read their profiles and know what they do. Then prepare questions specific to their area of interest.

4. Contact people you may know who were at the program, or who work closely with the program. Mention these people during the interview.

5. Do a mock interview to get comfortable with the interview process. Print out a list of general interview questions, as outlined by the American Association of Medical Colleges; (https://services.aamc.org/careersinmedicine/downloads/sampleinterviewquestions.pdf), and get a friend to objectively evaluate your interview performance. Listen to the feedback.

6. Know your application and projects are working on, in detail (but don’t discuss clinical trials).

7. Practice small talk. Know current events, read a non-medical book, think about your hobbies and practice talking about general topics. You are still being “interviewed” and making an impression when you are not in the formal interview.

On the Interview Day

1. Be on time.

2. Be impeccably dressed in a suit (preferably black and all one color). Your appearance is a sign of respect to the interviewer. For males; hair neat, clean shaven, shiny shoes, nails cut, crisp and clean shirt. For females; not too much make-up, hair neat, small earrings, nails cut without polish, shoes shined with small heels.

3. Carry nothing or a small slim case. Have a pen available. Turn your phone off, and don't play with handheld devices.

4. Project confidence; look awake and interested at all times. Take notes. Ask questions. Be the first to introduce oneself and have a firm handshake.

5. Interact and be friendly with the other applicants. Don't make any off-color jokes at any time during the interview day.

6. Thank the people you interview with at the end of the interview, and the program coordinator at the end of the day.

During the Interview

1. Make good eye contact.

2. Good posture and body language. You can use your hands, but not too much.

3. Listen when the interviewer speaks.

4. Make sure you actually answer the question that they have asked. Don’t ramble.

5. Try to set yourself apart from the other applicants. Don’t just give basic, common answers.

Questions You May Be Asked

How did you hear about this program, and why did you choose it?
What are you looking for in a program?
Do you know anyone in the program?
Why should we pick you to be in our program?
What do you think is the importance of leadership in medicine?
What do you think makes a good leader?
How important is teaching to you?
What do you think are the challenges you will face as a resident?
How do you handle conflict?
How do you accept failure?
What qualities do you think makes a good physician?
What are your strengths?
What are you weaknesses?
What is it you like in research?
If your house was on fire and you had one thing to grab, what would it be?
Tell me about this deficiency on your application?
Tell me about this current work you are engaged in?
What do you think is more important, action or the intention to take the action?
What are you going to do if you do not match this year?
Tell me about an interesting case that you saw in the field of ____?
What makes you happy?
Whats the difference between healthcare system in America and your country?
How do you deal with stress, in the moment of a stressful situation?
Give me an example of how you have handled a stressful situation.
Tell me about your mentor. How is your relationship with him/her?
When did you know you wanted to be a Physician, and why?
What are you planning to do after residency?
Where do you see yourself after 5 years or 10 years from now?
Tell me one example when you were a part of a team managing a patient and your contribution made a significant positive change in the management of that patient?
Tell me about one thing that you have done independently without any body's help and for which you are very proud of?
Comment on Obama's health care policies?
Why did you decide to come to the USA for residency and are you planning to go back to your country after residency?
Tell me about yourself.
Tell me about your home town.
You graduated medical school in ____. What have you been doing since that time?
How is the day going so far? What did you learn at the morning conference?
Where else have you applied / where else you have interviews at?
How did you get here? Where did you stay last night?
How was the pre-interview dinner last night? Who did you meet with?
If you don't mind me asking....followed by innapropriate question about race/ethnicity/marital status/sexual preference? Know how you would answer this as it does happen even though it is not supposed to!

Questions for the Interviewer

These should be insightful questions that aren’t about you, they are about the program, and the interviewer.

1. “When you were interviewing for residency what was the single most deciding factor for you in choosing the program you wanted?“

2. “How do you like living in the area of ____? What do you like about living in this area?”

3. “What is biggest challenge you encountered during your residency training?”

4. “What is the most rewarding aspect for you in being a part of this program?”

5. “What would you say is the strongest aspect of the residency program?”

6. “Can you tell me more about your work on ____. Are there chances for residents to get involved with your work in ____?”

7. “What interests you most about working with ____ patient population/ within the specialty of ____?”

8. “What do you feel are the most challenging aspects about working in the field of ____.”

9. “What are your goals for the residency program?”

10. “What particular characteristics you are looking for in an applicant? What do you think makes a person successful in this residency program?”

11. “What is your perspective of the culture within the program?”

12. “How would you describe how the residents work together? How would you describe how the residents and the faculty work together?”

13. “How do residents in the program work with members of an interdisciplinary team? With residents and attending in other specialties?”

14. “Could you tell me more about these changes you are incorporating into the program/ the new seminar entitled ____ starting in 2013? 15. "I see you have been with the department for ____ years. What makes you stay here?"

DO NOT ASK

About moonlighting opportunities, or the pay (you will look money oriented)

About the call schedule (you might appear to be wary of hard work)

About apartments/ fun activities in the area (an insult to the interviewer- they are not a guidebook)

About anything that might imply a weakness on your part (eg. asking about need for time off for possible illness etc)

About anything to do with politics, religion, or their family (too personal and controversial)