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Preparing for the Residency Interview

The interview is perhaps the most anxiety-provoking aspect of the residency application process, but possibly the most important. It serves as a means for a program to find out about you and whether they believe you would be a good fit into their residency. However, and perhaps more importantly, it is an essential way for you to get to know a program, its strengths and weaknesses, and culture, and whether it is a place you feel would be the best ‘match’ to spend (at least) the next three years of your life.

Although interview day schedules vary somewhat between institutions, there are several activities that are common to most. Some programs offer pre- (or post-) interview dinners or other social activities with residents intended to provide an opportunity to interact with current housestaff outside of the formal interview process. The actual interview day typically begins with an orientation to the institution and residency, with discussion of the educational program and more practical matters such as salary, benefits, and support services. A tour of patient care and educational areas where you would be training and learning is almost always included. 

Some programs provide an opportunity to participate on rounds with an inpatient team or with residents in an ambulatory clinic. Most programs offer between two to five interviews with staff, residents, or both. Finally, there is usually an exit interview at the end of the interview day with someone from the program leadership (such as the program director, an associate program director, or chief resident). Interview days tend to be long and exhausting, particularly if travel to and from the program is distant and you participate in any pre- or post-interview activities; this needs to be considered when planning your interview schedule.

Although many applicants do not look forward to residency interviews, remember that much of what you get out of your interviews depends on your attitude toward the process and what you seek to accomplish through the experience. Remember that the interview process is the one (and possibly the only) opportunity you have to actually see and experience what a program is like – important information for making a major life decision!

Important things to know about residency interviews

  • Residency interviews differ significantly from medical school interviews. When applying to medical school, you were much younger with no medical and limited life experience, and were looking simply to find a place to learn to be a doctor. But now you have chosen a specific field, and programs are looking for the “best and brightest” individuals who will fit in well with their current residents and institutional culture. Consequently, the nature of the interview relationship is markedly different between medical school and residency training – a program may be just as interested in recruiting you as you are in seeking to match at a particular program.
  • Residency interviews tend to be more like a job interview than an application to a school. Although many residency programs are affiliated with medical schools, they are looking for trainees who are willing and able to take on the clinical care of a large portion of their institution’s most complex patients as part of the educational process. Therefore, they want not only competent ‘students’, but also people who will be able to effectively manage the responsibilities associated with patient care.  Or, in other words, they are looking for individuals who will be their professional colleagues in the teaching, learning, and patient care process. Consequently, the nature of the interviews tends to be more conversational and collegial as they try to find out about you and see if you would be a good fit for their program. Very few (if any) residency interviews are confrontational or intimidating; interviewers might ask some challenging questions, but these really do not differ from those that might be asked in the course of an interview for any professional job (see sample questions below). Also keep in mind that most programs are looking at you with a longer time horizon than you may think. As opposed to medical school where it is expected you will complete your studies in four years and leave, residency programs are looking to see if you may be someone they eventually might want to ask to be a chief resident, fellowship trainee, or faculty member, similarly to someone applying for a permanent position.
  • In residency interviews, expressing who you are is as important as what you know. Virtually everyone applying to an internal medicine residency is smart, and program directors can glean this information fairly easily from your transcripts, exam scores, and letters of recommendation. The fact that you were offered an interview means that you are a reasonable candidate based on your medical school accomplishments and recommendations. What is more difficult for programs to understand is what kind of person you really are – your values, the motives that have led you to pursue a career in internal medicine, how you view caring for patients and interacting with others, your professional hopes and dreams, etc.  Because of this, it is important that you be prepared to help them see you for who you are. This can be done through your curriculum vitae and personal statement, but the interview is a way that programs seek to discover the person behind the application materials.
  • Residency interviews are an extremely important part of the process. Students frequently comment that interviews seem like a time consuming and burdensome part of the residency application process, and the significance of the specific information they take away from interviews is unclear. Many students find interviews on the surface to be minimally helpful – the curriculum seems to be the same everywhere (which it pretty much is), you are told how strong the educational program and commitment to teaching is (without being able to know if this is true), and the tour is fairly programmed (since most hospitals and clinics look the same), etc. However, what you get from visiting a program is invaluable in helping you decide on whether to rank a program and at what level.  Actually seeing and experiencing the educational, clinical, and social atmosphere of a place is worth more than any brochure or website can relate. And, assessing whether a place “feels right” and whether you can envision yourself working there next year and beyond may be one of the most helpful pieces of information you can have in making your final rank list choices.    

Practical considerations to keep in mind

  • Make sure you follow the general guidelines of interviewing (next section). Although you may be accustomed to having the flexibility and casualness that being a student affords, remember that residency programs are evaluating your candidacy for a professional clinical and educational position. Therefore, how you present and comport yourself and interact with others is an extremely important part of the interview process.
  • Pay particular attention to the residents currently in the program. Residents are perhaps the best barometer of what life at a residency program is like. Although the opportunities for direct interaction with residents will differ between interviews, and programs will undoubtedly want to expose you to their strongest, most satisfied trainees, it is usually possible to get a sense of how happy the residents are and what the quality of their educational experience is like. It is important for you to ask questions of them that are important to you, and remember that no program or institution is perfect. Ideally you would like to hear a fair and balanced assessment of the strengths and weaknesses of a program, and how satisfied the current residents are with their educational, patient care, and personal experiences. This is perhaps one of the most valuable things you can take away from your interview day.
  • It is OK to ask important questions of your interviewers. Interviewers, for the most part, expect you to ask specific questions about the program and institution, and if they are unable to provide an answer, will most likely refer your question to someone who can. That said, your questions should be reasonable and insightful, and not make it appear as though you are “checking off” items on a list of requirements you want a program to have or are overly focused on specific issues such as work-life balance or fellowship matching. Rather, it is important to ask questions relevant to your interests and show them that you are critically analyzing the program. You should definitely have a list of questions prepared, and do not be afraid to ask the same question many times over to different people during your interview day which should provide a broader perspective of the program.
  • Be open and honest with your interviewers. It is important to deal directly with any specific issues that your interviewers might raise, such as prior academic difficulty or any other concerns they may have with items in your application materials. Answering truthfully, credibly, and candidly is part of demonstrating collegiality and professionalism, even with difficult topics. 
  • Don’t overly focus on communicating a level of interest in a particular program. You should be as honest as possible if asked about your level of interest in a program. Programs rarely use an expression of interest on the interview day as an indicator of if or where they might place you on their rank list. It is disingenuous to indicate a definitive level of interest in all of the programs at which you interview. However, if you are genuinely considering ranking a specific program highly, it is OK to say so.
  • Do not place significant weight on online residency review sites that you may review either before or after your interview. As with most open websites, those who write tend to be those who have either had a very bad or very good experience at an institution, and this information is therefore fairly suspect in terms of its usefulness in helping you genuinely evaluate a program.

General guidelines for the interview process

  • Be respectful and courteous to the administrative staff, including when you are scheduling your interviews. The residency administrative staff put tremendous effort into working with applicants and usually try to accommodate reasonable requests and assist you in the interviewing process as much as possible. You should respect these efforts and make sure your interaction with these important individuals is professional and collegial as this may also be reflected as a component of your application.
  • If you either must or decide to cancel an interview, it is important to let the program know, even if your cancelation is at the last minute. Programs put considerable effort into the interview process (such as arranging for individual interviews and ordering food), and letting them know that you will not be keeping an interview date for whatever reason is a matter of courtesy and professionalism.
  • Dress appropriately - Conservative is always appropriate, and good grooming is essential. Remember that you are interviewing for a position in which you will be interacting with patients, their families, and other professional colleagues, and you should dress in a manner that is appropriate for this role.
  • Be on time - You should have to wait for them, they should not wait for you. 
  • Demeanor is important - Be attentive, honest, and as much as possible, relaxed. Interview days tend to be long and intense and you will get exhausted, but try your best to always be cordial and appear interested. Remember that the people you interact with on your interview day will be paying attention to your interpersonal skills and professionalism, even in this highly compressed time frame.
  • Attend pre- or post- interview dinners if you can. This is an excellent opportunity for you to meet with the current residents and talk about life in the program, and can help greatly in your rank list deliberations. However, remember that your behavior and actions during these events should be appropriate and this time interacting with the residents should be considered a part of your interview.
  • Review your personal statement and curriculum vitae prior to the interview. Interviewers may ask you to expound on or otherwise explain a portion of your application and you should be prepared to do this.
  • It is helpful to know something about the program before your interview day. Although you will likely not know with whom you will be interviewing, it is helpful to know major facts about a program and institution (such as clinical or academic areas of focus); this may facilitate knowledgeable discussion in your interviews with faculty and staff.
  • Questions - You should be prepared to answer, as well as ask questions. A list of questions commonly asked by faculty interviewers can be found in the section below, and thinking about these question topics ahead of your interview day may be helpful.

Questions commonly asked at residency interviews

"Why do you want to go into internal medicine?"

"What are your ultimate career plans?  Are you planning on a subspecialty?  What field?"
Note: It is perfectly acceptable to say 'I don't know' to this question. An interest in a subspecialty is not mandatory. Internal medicine is a broad area, and not knowing what you want to do before you have started training is certainly reasonable. This question is to get an idea of your area of interest and whether or not you may be heading in a certain career direction. It is also fine to have more than one subspecialty in mind.

"Where do you see yourself in five years? Ten years?"

"How do you feel about the practice of medicine today?  What about its future? (i.e. malpractice, insurance, reimbursement, etc.)

"What is your biggest fear in the realm of medicine?" (or questions concerning the state of medicine in general)

"Why do you want to come to this program?"

"What makes this program appealing/special to you?"

"What do you hope to gain from our residency program?"

"Why should we want you to come to our program?"

"What will you/can you bring to our program?"

"Briefly describe your student research project." (if applicable)

"Do you plan on research as being a part of your career?"

"Tell me something about you that is not on you CV."

"Give me some one-word descriptors of yourself."

"What are some of your strengths/weaknesses?"

"Tell me about your hometown/college/medical school."

"Why did you choose the college/medical school that you attended?"

"Describe the best/worst incident that you encountered in your medical school career."

"Who is your role model?  Why?"

"What are some of your hobbies/interest/extra-curricular activities?"

"What is the most recent book you've read?  Tell me a little bit about this book."

You should be prepared - interviewers may pick something on your curriculum vitae (i.e. extra-curricular activities, work experiences, research project, etc.), personal statement, ERAS application, etc. to ask you about. Remember what you wrote; review these documents prior to interviewing so you are not caught off guard by these questions.