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How To Master The Medical Residency Interview

Once you have been invited to a residency interview, how you are perceived on interview day becomes the most crucial factor in determining how you will be ranked. It is important to understand what interviewers are looking for within the context of your experience. Residency applicants often fail to make a good impression when they try to tell interviewers what they think they want to hear instead of representing themselves honestly and authentically.

Since your grades, USMLE scores and letters of reference will be used to evaluate your academic aptitude, interviewers are trying to assess something else – they want to know if you are really committed to the specialty to which you are applying, that you have a mature sense of what it means to practice your specialty and how good your interpersonal and communication skills are – among other attributes.

Above all, interviewers are trying assess your “fit” for a program. Residency is intense and you will be spending a lot of time with the individual interviewer, his colleagues and his residents. So, your interviewer is fundamentally trying to determine if he likes you and would be happy to see you at 3 AM when he is tired. Residency interviewers are not looking for the same subtleties that your medical school interviewers were; they assume that you want to be a doctor.

You should, in part, view your residency interview as a job interview; they want to know that you can get the job done reliably and competently. Interviewers also want to rule out any red flags, such as gaps in time on your application. And, above all, they want to figure out if you are likable and would make a positive addition to the program.

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Before The Interview

Responding To Interview Requests

You can start receiving residency interview requests very soon after you submit your ERAS application. Generally speaking, less competitive programs extend interviews early (mid/late September) while more competitive specialties and programs will extend interview requests in October or early November. 

Interview requests will arrive via email and we encourage applicants to check email often and respond to interview requests as soon as possible since interview slots can fill up quickly. Some requests will come through services called interviewbroker.com or thalamusgme.com where you can select available interview dates from an online calendar. A few programs do things the old fashioned way and will email you a list of possible dates and ask for an email reply with your first, second, and third choices. 

Research The Program

Since programs not only want to find the best applicants but also those who are the best fit for their individual program, you must know the details about each and every program where you interview. Review the program’s curriculum, clinical sites where you will be doing rotations, faculty and resident interests and any recent changes they are promoting. Have an idea of what the residency is “known for.”

For example, does the program emphasize research or teaching? Seeking out information may be easy for some programs, but others may have poor websites. For programs that have less than stellar websites, you should seek out information from current residents or recent graduates or rely on interview day to become informed about the school. You should also research the current chair, program director or any other significant leadership or faculty so you know about their interests; this will give you an idea of the program’s strengths. Also be sure to know something about the city where the program is located and be able to express why you would be happy living there. Feel free to bring up whatever you have learned through your research when asked “Why our program?” You may be able to glean some information if the program offers a dinner or happy hour before interview day.

Residency Interview Questions

  • Tell me about yourself.
  • Why this specialty?
  • Tell me about a negative aspect of the specialty.
  • Where do you see yourself in the future?
  • What is your greatest strength/weakness?
  • If you had a free day what would you do?
  • How do you achieve balance in your life? 
  • Tell me a joke.
  • Teach me something.
  • What experience(s) made you want to pursue this specialty?
  • How would your best friend describe you? 
  • What would he or she say is your greatest weakness?
  • Tell me about an interesting case.
  • What is the one thing you tried really hard at something but didn’t turn out as expected or what has been your greatest challenge?
  • Did you ever have to work to help support yourself or fund your education?
  • How do you remember everything you have to do?
  • Would you change anything in your background? 
  • Tell me about your research/clinical work/volunteer experience.
  • Explain your academic path.
  • What strengths would you bring to our program?
  • Explain your poor grade/USMLE/academic performance.
  • Tell me about an ethical dilemma.
  • What qualities do you possess that will help you to become a great XXX specialist?
  • Tell me about the most influential person in your life.
  • Tell me about your most valued mentor.
  • What is your most valuable accomplishment?
  • What leadership roles have you held?
  • Why should we choose you?
  • Describe your perfect day.
  • Where do you see yourself in the future (10, 20 or 30 years)?
  • If you could change anything about your education, what would that be and why?
  • What kinds of books do you read? Tell me about the book you read most recently. 
  • What do you do for fun?
  • In closing, is there anything else you would like to tell me?
  • Do you have any questions for me?

Prohibited Questions

Programs are not allowed to ask you questions about ranking programs, where you are interviewing, your sexual orientation, race, age, religious affiliation, marital status or plans to have children. However, sometimes interviewers ask questions that touch on these topics, often by accident. Sometimes interviewers will push for you to offer specifics. If they do, you are in a bad spot and you should be honest. Programs also should not pressure you to tell them where you are ranking them. Assuming there is no malintent or bias involved and you don’t want to “call out your interviewer” for asking an illegal question, we suggest gently redirecting the question with your answer. Three examples are below:

  1. Where else you are interviewing?

If you are asked this question, I suggest you politely say something like, I am interviewing at a range of programs on the East Coast primarily. However, I really like this program for the following reasons (list them).”

2. How you will be ranking our program?

This question is a violation of the Match Participation Agreement. It’s best to respond like this: “I really have no idea how I will be ranking programs right now. I have really enjoyed learning about this program, however, for the following reasons.”

3. Congratulations on your marriage. Do you think you will be having children soon?

“My husband and I are really excited about this next step of my medical training and right now our focus is on enjoying interviews and travel and finding out where I will match in March.”

For more information read the Match Communication Code of Conduct.

During The Interview

Basic Guidelines

There are some basic guidelines to follow that will help your interview day go smoothly.

Greeting People

Make eye contact with and introduce yourself to everyone you meet and smile naturally! Never call anyone by his or her first name; use his title and last name. If you aren’t sure of the person’s title, it is always safe to start off with “Dr. XX.” Do not extend your hand when you meet someone; instead let him take this initiative since he is senior to you. Have your right hand free so you are prepared and shake hands firmly if presented with this opportunity. Respect the personal space of everyone you meet. Throughout your interview day, be sure to speak at a normal pace, with clear diction, in a normal tone and volume and in a formal conversational manner. Speaking informally or using slang words anytime during the interview day puts you at risk for being perceived in the wrong way.

In The Office

As you enter someone’s office, allow her to suggest where you should sit. If she doesn’t do this, wait for her to sit down first and then sit across from her where it seems most natural. Sit up straight and do not slouch. Place anything you are holding on the floor beside you. If you aren’t sure what to do with your hands, fold them comfortably into your lap. It is okay to use gestures while you converse, but don’t go overboard. Do not forget to smile and try to appear positive, energetic, enthusiastic and warm. Be sure to make eye contact with your interviewer throughout the interview, especially when she is talking. This demonstrates that you are attentive. This behavior will make your interviewer like you—a primary goal. Do not be offended if your interviewer’s pager or cell phone goes off and she needs to answer a call. This is medicine and things come up. That said, your phone should not be visible or audible during interview day.

Make A Good First Impression

Even if it is subconscious, your interviewer makes a judgment about you within the first five to 10 minutes of your interview.  An initial positive impression causes a “halo effect” and will affect everything you say in a good way. Similarly, an initial negative impression will cast a shadow, making it tough to redeem yourself. Making a good first impression is based not only on what you say but on your general demeanor. Are you professional, poised, energetic, positive and enthusiastic? Do you smile and make eye contact? Are you well-groomed?

The impression you convey in the first few minutes by your overall attitude, energy, tone of voice, expression and posture will set the stage for everything that follows. Remember never to say anything negative during an interview about other schools or people, which may give a poor impression.   

Even small talk at the appropriate time can have an important effect, either positive or negative. You might find yourself speaking with a member of the faculty who is not interviewing you before the program presentation, for example. If this person has a strong impression of you, whether positive or negative, she will likely express it when your candidacy is discussed.

Create Your Own Agenda

By agenda, I mean an outline in your mind (you don’t want to display a crib sheet) of the key things about you and your experiences that you would like to discuss. This is essential because you cannot rely on your interviewer to ask about everything you would like to discuss, even all of your key experiences; you must take responsibility for bringing them up even if you wrote about them in your application. Remember that even if an interview is open file, your interviewer may not have had the time to review your materials. Also, think about how your experiences and values are similar to those of the program and speak about them within this context. Also, if you have any future rotations or experiences planned later in the year that are related to the specialty, be sure to bring them up. 

Make The Interviewer’s Job Easy

When I interviewed applicants, the most painful interviews were those that made me feel that getting information from an applicant was “like pulling teeth.” In contrast, the easiest interviews were with candidates who had a lot to say that was pertinent and important. These interviewees were obviously better prepared, which impressed me because it indicated that they were taking the interview seriously enough to practice. Applicants who gave brief answers forced me to dip into my “interview questions bank” since they said so little. Ideally, you should make your interviewer’s job easy by providing her with insights and anecdotes and making segues. You don’t want to ramble, but as long as you stick to the agenda you’ve created, it’s most likely that you will stick to pertinent topics while making things simpler for your interviewer.

Make Segues And Give Complete Answers

Again, this comes back to the idea that you are in control. Make segues to topics you would like to discuss. For example, if you are asked why you want to pursue a certain specialty, explain not only “why” but “when” and “what.” Tell the interviewer when your interest started and what you have done to explore it. If you practice doing this, your segues should become natural and conversational, and your interviewer will remain engaged in what you are saying. By making these references and elaborating, you will naturally inspire further discussion and create prompts for your interviewer.

Try Your Best To Make Your Interview Conversational

The more experienced interviewers will naturally try to make your interview conversational but, just like any conversation, your interview is a give and take so do your best to keep the flow going. At the same time, be sure that you keep an air of formality to your interview even if your interviewer becomes too informal. Also, try not to dwell too much on one topic or to get off topic. Unless you are interviewing with a  chairperson or someone who is very experienced and you feel like you have already covered many of the basics of your experience and motivations, it is usually only an inexperienced interviewer who allows the interview to get off track. It is your job to make sure this doesn’t happen.

Interview Length, Schedule & Format

Interview visits typically consist of a “night before gathering” and the interview day itself both of which which are explained in greater detail below.

Pre-Interview Day Gatherings

Many programs have a dinner or happy hour the night before interview days. These events are generally recruitment efforts and are usually attended by current residents and applicants. You should dress in “business casual” attire for these events and can bring a “significant other” only if the program offers this option. You want to be social at these events but do not be too informal. Don’t say anything that you wouldn’t say directly to the program director. My residents would routinely come to my office the day after these dinners to tell me whom they did and did not like. So, even though you aren’t being formally evaluated at these dinners, it’s wise to try to make a good impression.

Here are some general guidelines for these “evening before” gatherings:

  1. Don’t say anything that you wouldn’t want the program director to hear.
  2. Don’t spend time chatting with another applicant about another program.
  3. Order one alcoholic drink if everyone else is having a drink and you want one – but only if you are used to drinking alcohol. Do not order more than one drink.
  4. If you are ordering from a menu, do not order the filet mignon for $45 if everyone else is ordering a burger for $15.
  5. Go home after the event. Even if the residents invite you out for more social activities, kindly decline the offer and say, “I really want to get some sleep. Tomorrow’s interview is really important to me.”
  6. Take note of whether or not residents are at the dinner. Sometimes the guests primarily are faculty,  but typically these functions are intended to provide informal opportunities for candidates to talk to the residents. You should be skeptical if your contact with the residents is limited. This may mean that either the residents opt out of events or residents were not invited. In both cases, this may imply that residents are not happy with the program.

Interview Day Schedule

Interview days vary but follow a general pattern. Typically, smaller programs will have only two to three interviews of 30 minutes each. But, larger or very competitive programs, may have up to ten very brief interviews lasting 15 minutes each.

Below is a typical interview day schedule:

  • 8:30 AM:  Arrive at the interview office
  • 9:00 AM: Presentation by program director 
  • 10:30 AM: Tour of facilities
  • 12 noon: Lunch with residents
  • 1:00 PM – 3:00 PM: Interviews

The presentation and tour can give you tremendous insight into a program’s philosophy, structure and stability. For example, if the program director is not present on interview day and the assistant director is is instead giving the introduction, you should be concerned about the program director’s commitment to the program, her organizational skills and the training that you might obtain in this program. Conversely, when the department chairperson makes it a point to speak to applicants on interview day, it suggests that the departmental leadership is invested in resident education. This is essential because the chairperson typically determines how much funding is allocated to the residency, which directly impacts resident education.  In addition, the chairperson’s involvement in resident selection suggests that the residency and departmental leadership collaborate, an important aspect of running a department that is truly focused on education. 

Do not feel you must ask questions during the orientation and tour. One or two applicants usually dominate these sessions and, unless they have an established rapport with the presenters, these individuals are not usually perceived in the best light. It is best to pay close attention and to show that you are doing so by making eye contact with the speaker. You may take notes during a program presentation but, as mentioned elsewhere in this book, do not take notes during your actual interviews.

Since many programs interview multiple candidates on any given day, a tremendous amount of planning and coordination is required to keep everyone on schedule. For this reason, interviews often run late, residency coordinators knock on interviewers’ doors five minutes before interviews are scheduled to end to “keep things moving” or may even call interviewers when time is up. If a program is seriously behind schedule, however, you should wonder about the overall organization of the program. It is not your responsibility to keep your interviewer on schedule, however. Allow your interviewer to decide when your interview will conclude and to keep track of time. Every program has faculty who are notorious for “going over.” If you are late for an interview because the previous one was longer than expected, you can apologize and say, “I am sorry I am late. My last interview went over.” 

Interviewers

You may be interviewed by faculty, residency leadership (including the program director and associate program director) and current residents. Because your interviewer is your advocate and the primary support for your candidacy, it is essential to get on her good side. She (or he) will “sell you” to the other faculty. Your interviewer typically makes or breaks your acceptance. If she thinks highly of you, you will be ranked highly, but if you don’t make a good impression, she will not support you. Remember your interviewer is human and, most of the time, is not trying to “get you.” She wants to find out about you as a person and if you will be a good fit for the program. Because you cannot predict or control who your interviewer will be, it is important to have broad appeal as an interviewee and prepare yourself for multiple scenarios.

After The Interview

Thank You Letters

Write thank you notes or emails. They are unlikely to influence your candidacy, but it is good manners to write these notes. Make the note short and sweet and mention anything that was a highlight of your interview; also repeat that you are interested in the school and thank the interviewer for her time. Sometimes the residency coordinator will give applicants suggestions for contacting their interviewers so, if they do, be sure to follow their directions. But wait until you get home to send your thank you notes. I remember the candidate who was writing her thank you notes in the conference room during interview day. She handed them to the secretary before she left. This seemed contrived and insincere.

Interview Second Look

The most recent program directors survey indicated that second looks do not impact a candidate’s ranking, but I still suggest that applicants attend second looks if they are offered. Why? Suppose you meet someone on a second look who really thinks you would be a great fit and puts in a good word with the program director on your behalf? Since the residency match has become more competitive, I suggest that applicants do whatever they can to give them an edge. I think second looks are especially important for programs where you interviewed early in the season to remind them of who you are.

Letter Of Intent

We encourage applicants to send a letter of intent to their number one choice program. Interestingly, more programs are actually encouraging applicants to communicate interest. We find that a letter of intent, which states that the program is your top choice and you will be ranking them #1, can influence an applicant’s ranking in a positive way since programs would rather match with applicants who are enthusiastic about their program and not go “too far down their rank list.”

Residency Match “Love Letters”

Some programs write “love letters” to applicants after they interview, telling the applicant that she would be a great fit for their program. Based on my experience, I find these letters are often misleading and insincere and in no way guarantee a match. I suggest that applicants reply graciously to such letters but don’t ever think a letter means that you “are in.”

About MedEdits

MedEdits helps students get admitted to medical school and residency programs. Our consultants have years of experience serving on medical school admissions committees, and as faculty members at the top medical schools in the country.

Need Help With Your Residency Interview?

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