MASTERING THE INTERVIEW

Every fall and winter thousands of fourth year medical students travel hundred of miles for an interview as they seek their ideal residency.  A survey done by the National Residency Match Program found that the interview is the most important tool used in ranking candidates, more important than clerkship grades or USMLE Scores. Seniors in the United States have a median of eleven interviews in the student-ranking program.  If you do an internet search, you will find thousands of results that are devoted to the interviewing process and numerous questions.  It can seem overwhelming.

I will short-circuit your search and give you all the steps needed to make you a successful interviewer, and Unforgettable.

What are they looking for in YOU?

  1. Do you have the qualities, experience, personality, mental health, and stamina to be a good resident in their specialty?
  2. Will you fit well into their program and their specialty?

What should you look for in their program?

  1.  Will the program prepare you for your specialty?
  2.  Does their program have the major strengths to fulfill your needs?
  3. Do you feel comfortable with the staff, the environment and atmosphere where you will be working? Is your emotional brain at peace?

General Guidelines:

  1. Avoid a “generic interview”- it is your time to stand out.
  2. Like a good marriage the more compatible the fit, the better for both the residency and you.
  3. If you are extremely interested in a program, consider doing a visiting elective there before your fourth year. Talk to as many people that are involved in the decision making process; especially, the program director. Be someone they know when your name comes up for review.
  4. Send out 10-30 applications (depending on how competitive the specialty) so you can be assured you will get one of your top choices.
  5. Make sure you have all the requirements for your chosen specialty and the institution of your choice.  ENT and Orthopedics will want you to have had some research experience.  Family Medicine wants some demonstration that you have leadership ability, the personality to deal with people, examples of volunteerism in an underserved area or some mission work.
  6. Once you obtained a list of your interviews, choose the least likely interview as a “dry run” or practice interview; especially, if you know you will have 10-12 interviews.  Design your visits to have your most desired in the middle of your list so you can have enough time before the match.
  7. Most of the interviews take place between October and January so plan appropriately. Applying early gives you more flexibility.
  8. When you get your letter of invitation for an interview at LLUFM Residency program they will give you the days for the interview.  This will help you decided when you can fit the visit into your schedule. At this program you will be interviewed by three people, one will be a resident of the program, the director of the program and another faculty member. In addition, you will then have a group interview (group interviews tend to be more daunting for students) with ethical cases. It is suggested that you review the AMA Ethical Codes in preparation for the exercise.
  9. You will be invited to an informal dinner the night before the interview, a schedule of the interviewers, and a planner for the day.  It will take most of the day.  Before the interview there is a tour of the campus and facilities.  Many programs will try to give you a taste of their noon conference.

Step 1. Preparation 1-2 months before the interview

  1. Do a mock interview with individuals that do not know you but have experience in interviewing candidates.  Make it as realistic as an actual interview.  Of course, this interview should have feedback, and suggestions for your future performance.  If videotaping helps you, do it. I would do multiple mock interviews until you feel prepared.  Repetition is the mother of learning.
  2. While most applicants will review the program’s website, I suggest you perform a more complete search to learn more about the program, its faculty, the hospital, and the city. Well before your interview, contact graduates of your medical school who are residents or faculty at the program. Locate physicians in your area who trained at that program. In addition, the Alumni Association School of Medicine of Loma Linda University have asked alumni to provide housing and hosting for the interviewing seniors.  They want future alumni to feel welcome.
  3. Start preparing questions that you would like to ask the program director, other faculty, and the chief resident.  Review the most common questions that they will ask you (I will provide these).
  4. Buy a professional leather folder to carry your application information (CV, PS, Transcript, Printout of the Departments Webpage), a list of your interviewing sites, thank you notes, your impressions and reflections of each program after the interview
  5. Decide what you should wear during the interview.  Remember what you wore to get into medical school.  A well-groomed professional look that let’s them know you’re a serious candidate. First impressions matter!

What to do the evening before the interview?

  1. Review the information that you have about your host residency: their philosophy, the details of their program, reasons why you want to come to “their hallowed halls”.
  2. Review the most common questions that they are likely to ask you and the questions you would like to ask them.
  3. Make sure you know who, where, and when you meet in the morning.   Review the schedule and campus locations.
  4. Attend any pre-interview function that will help you be memorable.  Remember, you are on review at all times, enjoy the experience.

What to do the day of the interview?

  1. At Loma Linda Family Medicine Residency Program the interviewee would go to the Residency Secretary. A flash drive has been sent to their candidates after receiving confirmation of an interview.
  2. You will get a more detailed schedule that will tell you who the three interviewers are and where to meet them.  They will also tell to where the group interview will be.
  3. Attend every activity of the day: lunch, conferences, tour of the campus, and all scheduled functions. Your enthusiasm, interest, and involvement are indicators of your value for their program.
  4. Record the names of all the staff and faculty that helped you, so you can send them a note of thanks. Again, another tickler for remembering you.

What to expect during the actual interview?

  1. Your interviewers are evaluating you by your response to their questions, your comfort with small talk, your body language, and your memorable parts.
  2. Greet them with a smile, a handshake, and a look in the eyes.  Tell them how nice it is to be there.
  3. The more prepared you are with practice; a thorough study of questions and responses, the more relaxed you should be.
  4. This is a wonderful opportunity to highlight your remarkable accomplishments, experiences, leadership positions, research, and other qualities.
  5.  Watch for opportunities to fill in details you perceived you left out.

Questions that  are the most commonly asked and most difficult:

  • Tell me about yourself.  You should practice this so it is condensed to 1-2 minutes and “show cases” your most memorable self. Have at least 5 key attributes.
  • What is your greatest strength?  Describe what you want them to know especially something you can bring to the program and give an example.
  • What is your greatest weakness? Be genuine but not too graphic (insensitive and lazy).
  • What makes you stand out as an individual?
  • Tell me about Loma Linda University School of Medicine. Many interviewers may not know much about your institution.

Example: LLUSM is a faith-based SDA school, 60 miles east of LA. We have 160 medical students who score above the national average on USMLE.  I had a quality education and my teachers and classmates were very supportive in helping me attain my degree.  It was a joy and privilege to attend and the school prepared me well to meet the challenge of your program. Make sure your facts are right and practice what you will tell them.

Questions that are most commonly asked by faculty:

  • Why do you want to come to our program?
  • Why XXX specialty? Number one asked question.
  • What are you looking for in this program?
  • Where do you see yourself in 5-10 years?
  • What are some of the issues in health care today and how will they impact this specialty?
  • What is an interesting case you participated in?
  • Tell me about . . . item(s) on your CV, etc.
  • Tell me about an interesting patient.
  • Did you ever have any problems in medical school?  Be prepared to answer any “red flags” in your record.  This is the time to be honest and positive about the experience.  An adversity should teach you something and make you a stronger candidate.
  • Tell me about your leadership roles.
  • What can you offer this program?
  • Did you ever lead a team that made a change in your medical school activity, design a survey, developed a cancer screen or the like?
  • What would you do if one of your senior residents did something wrong and you were there to observe it?

There are many questions that can be asked.  I would review two or three different sites to see the type of questions that you would be uncomfortable with.  Know the illegal ones and learn how to respond.  There are illegal questions about sexual orientation, marital status, children or future children, use of medications and specifics about your health.

Four good sources for questions:

  • Iserson’s Getting Into A Residency has a full chapter with forty pages with questions and answers. One of the more complete but has no cases that are used in some institutions.
  • AAMC  Don’t Forget to Ask: Advice from Residents on  What to Ask During the Residency Interview.  https://www.aamc.org/download/77936/data/residencyquestions.pdf
  • The Residency  Interview: Making the Most of It 
  • The Residency  Interview by  Jamie Collings, MD Residency Director, Northwestern 

 Questions that are asked by residents:

  • What rotations have you had?
  • Have you ever had problems with a faculty member or fellow student?
  • Do you feel comfortable making an independent decision?
  • Did you feel you got adequate training at your medical school?
  • Do you consider yourself a team player or an independent player?
  • Do you like to deliver babies?
  • Do you like inpatient or out patient better?
  • What kind of patients do you not like?
  • Do feel you are ready to be an intern?
  • What do you want to get out of our program here?

The resident is trying to figure if you would be a dependable, supportive, and pleasant colleague when the situation gets busy and stressful.

Questions that you have for faculty interviewers:

  •  What is your program noted for?
  • What is the pass rate for the specialty boards after completing your program?
  • Are there any areas of your program that you would like to change if you could?
  • Has your program filled by the match over the past 5 years?
  • Is your program unopposed or opposed?
  • Does every resident have to do a research project by their last year?
  • Are their any major changes that are going to take place in your program that I should know about?

Questions you would like to ask the resident:

  •  What attracted you to this program?
  •  Is there anything you would change about this program?
  • How would you rate the teaching and support of the faculty?
  • What is the patient population?
  • How busy are your night calls and clinic schedules?
  • Would you choose this program if you had to do it over again?
  • What aspect of this program do you find the most difficult to deal with?

Remember to develop your own questions that are important to you.

Cases: I use to see how a candidate will respond and detect prejudices and biases.

Case one:

Because Loma Linda University Medical School is rather conservative, I used this case to see if the student has a prejudice toward gay patients: An 18 year-old male comes in to get a college physical and tells you that he is gay and wants to know what you think about that?

Two  Responses: One senior told me that she would tell him that it is a sin to be gay.  Another told me that their church would not like it.

Response that I want:  No matter what the patient’s life style, sexual orientation or belief, I will give them unconditional, competent, compassionate care.

Another response: You could tell the patient that his sexual orientation is important to his over all general health; particularly in his exposure to health issues such as HIV, hepatitis, and various STD’s.   My greatest concern for you is to live a healthy, happy, and productive life.


Case two:

I like to use the Terri Shiavo case. To refresh your memory, She was a brain-damaged Florida woman who became the center of a protracted court fight over having her feeding tube removed. Husband wanted to honor her wishes to not be kept alive in a vegetative state and the parents wanted her kept alive no matter what condition she was in.

Answer: The husband has the durable power of attorney for his wife’s wishes so he has the final word.


Case three:

Another clinical dilemma that may be used is a delay in giving the patient a diagnosis.  For example a patient came in for a breast exam you find a mass that seems suspicious, you ordered a mammogram that week and you went on vacation.  She called in and was told the mammogram was negative. She came in 2 months later and you realized it had grown and was probably cancer and you had made a mistake.  How would you handle it and prevent it from happening again?

Answer: I am so sorry, I take full responsibility I should have taken your name given it to my nurse, gotten an ultrasound called the breast clinic and made sure your name was not lost to follow-up.  We now have a “breast” nurse who will handle all cases of suspicious lumps with a definite protocol- ultrasound and mammogram, with immediate appointment to the breast clinic.

What to do if you don’t know the answer:

If you don’t have an answer to a question you may have to say I just don’t know.  And say it with conviction.  Some questions are asked to get your reaction and composure not always an answer (judging your grace under fire).

What to do that night after the interview?

Decide how you would rank the program according to your criteria. I like the Perelman School of medicine

Residency Program Evaluation Guide found

www.med.upenn.edu/…/PSOMGuidetoResi

Write thank you notes to all the important people that had an impact on you including the secretary. Let them know you appreciated the time and hospitality that they extended to you.  This is another tickler for them to remember you.

You can in your note let your number one program know that you ranked them as your first choice, and some of the others that you are very favorable toward their program and are highly interested.

How to make your ultimate choice?

  1. Many of our important decisions in life like marrying, buying a house, and deciding on a residency are done with how comfortable and emotionally satisfying you feel.
  2. You want to believe that you make the decision because you will get the best training at this institution but if the “family of faculty and residents” don’t feel warm and friendly don’t go there.  You will be spending the next 3-5 years working with this group.
  3. Your final choice of which residency you will be going to will be made for you by the match, but you can show your enthusiasm and express your desire to come to their institution.  It will only help your chances to express how much you appreciate the qualities of their program and how their residency will give you the skill and experience you need.
  4. Some students will make their final decision based on the additional training at an institution such as a subspecialty or other areas of their interest such as ethics, end-of-life care, geriatrics or sports medicine.  Take that into account when you finalize.
  5. It is prudent to look into all three to five years of your training and what is expected of you during the whole program.

Comment: No decision is imbedded in concrete you can change your mind if the program is not for you.  I had a student who chose pathology and realized after one year that he liked dealing with patients and switched to family medicine and another that chose rehab medicine and switched to pathology because he didn’t like taking care of live people.

PODCAST

CONTENTS

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ABOUT THE AUTHOR

Dr. Barbara Orr ’70 is a loyal supporter of Loma Linda University School of Medicine and truly believes in the mission of this institution. Since October 1972, she has worked at Loma Linda University, initially as assistant director of the emergency department and then as a founding member of the family medicine department. She was the medical director of the faculty clinic for 10 years and then the predoctoral director of family medicine for nearly 12 years.

ACKNOWLEDGEMENTS

Roger Hadley, M.D. ’74
Montri Wongworawat, M.D. ’96