Say what you want about the weather, but it’s going to be 72 and fluorescent for a majority of your residency.
– A surgery resident
Part 3 is upon us! It’s out of order according to the plan laid out in my first post, but I don’t care! I make the rules around here! If you haven’t already, catch up with The NRMP Match Part 1: Understanding the Statistics – “Will I match?”, and The NRMP Match Part 2: My ERAS Application, which set the stage to read about the interview process. If you’re a rising MS4 (because people like me are graduating in two weeks. Later nerds! I kid, get ready to enjoy the best year of medical school), bookmark this post and read it the month before your first interview.
So, as I promised long ago, I’m going to explain what I learned about the interview trail. Furthermore, I’ll give you tips for success in landing the residency of your choice. As a bit of a background in case you didn’t read part 2: I went on 14 interviews this year, which I think is near the higher end of the spectrum. I’m no expert on the process considering I’ve only gone through it once, but it’s likely I’m the best you’ll get from a medical student perspective. There are plenty of faculty and residents who have interviewed candidates for years, but even then, they have only been an interviewee for residency once (or twice if they didn’t match the first time around and/or did a prelim year). It stands to reason that I basically have a Ph.D in interviewing for residency.
I’m pretty excited about this as opposed to parts 1 and 2, because this gets to be less about data and more about my personal experience and opinions. While I love to pile on the citations, tables, and charts (and the Oxford comma), I much prefer to speak straight from my intestines. And as we all know, the gut has 1 job that it does utter certainty: churning out poop. On that note, let’s get to it, with conveniently numbered steps because who doesn’t love lists?!
Step -1: Everyone Has an Angle
This goes for your mother, your program director, your faculty adviser, and especially for me. EVERYONE YOU ENCOUNTER who gives you advice has their own slant for whatever reason. That means you must take everything someone says with a grain of salt, AKA only believe them to a certain extent. Why do I make such a big deal about this? Because it’s a big deal!
Everyone having their own perspective means they have experiences that might slant their view unfairly. Despite the fact that those you ask for advice will likely be physicians, they are still human, bias and all. Their bias has a greater chance of chipping their opinion into the “less correct” territory, because bias makes us less likely to be objective. I’m going to do my best to give advice for everyone, but remember that it comes from my perspective. My perspective is as follows: I had 14 interviews in general surgery that were mostly in the Midwest, and I matched at my #2 choice (arguably should have ranked it as #1) of Saint Louis University. I interviewed at programs along the entirety of the community-academic spectrum except for the traditional “elite” programs such as Johns Hopkins, Harvard, Duke, Wash-U, etc. I did not interview any farther west than Omaha, Nebraska, nor farther east or south than Norfolk, Virginia. I went about as far north as possible to Minneapolis, Minnesota.
What I want you to take away from that paragraph is that I have a geographically restricted perspective as well as a lack of “traditionally top-tier academic research institution” experience. Something to be aware of is that geography matters. The regions of the country are different with respect to weather (duh), but more importantly in terms of program philosophy, the types of residents/applicants they attract, and the overall feel of the program. I’m a Midwesterner who preferred the feel of Midwest cities and Midwest programs.
The other thing that I’ll emphasize is that I matched at my #2 program in Saint Louis University (henceforth known as SLU). This could mean many things. I could have been an absolute baller of an interviewee and impressed all the programs I interviewed at. I also could have only happened to impress SLU, and was only ranked highly there. It could also mean I got lucky in how they ranked me, or that other applicants didn’t rank SLU highly, thus opening up their list to fall to however low I was. While there are plenty of possible realities that I will never know unless I find out where I was ranked (which it doesn’t matter because a match is a match, regardless of how/why it happens. Remember that), it does stand to reason that matching at my #2 when programs generally match between 4-6 residents is pretty good. With so few residents in surgical programs (as compared to 20-30 per class in a specialty like pediatrics), there is little room for the statistical protection and certainty that large sample sizes mean, so matching within your top 4-6 programs is fairly impressive. Smaller sample sizes = higher chance of chance causing the trend. Okay, done beating that horse. It dead.
Back to perspective and variance. I had anywhere from 2 to 14 different people interviewing me at a given institution, so I had at least that many perspectives on me as a potential resident. While there are likely similar perspectives on a candidate between two interviewers at a given program, they are still different. There is no way to give advice that will cover the entire spectrum of what people want when they interview you. I’m going to strive to give you the the most useful nuggets of info, as well as some things with my own twist.
WARNING: IMPORTANT PARAGRAPH AHEAD
I found a concrete example of perspective when I was talking to one of my surgical mentors about making my rank list. He pointed out 3 programs that he thought were a tier above the rest. He mentioned specific program directors by name, talked about people he knew at those programs, and encouraged me to rank them highly. There were other programs he knew about but didn’t recommend as highly, and somewhere between 5-7 that he had no idea about. I hope you can read between the lines here. While this surgeon has a good reputation for objectivity and giving good advice, it should be glaringly obvious that his perspective is slanted based on where he knows people. We trust the opinions of people that we trust, that’s how we work. But understanding that out of 14 programs, he had up to 50% that he couldn’t speak to their quality. Of note, of the 3 programs he emphasized, one was our home program at IU and one was SLU. I took his mention of SLU to heart, because up until that point I needed validation of my love for their program. I wanted someone external to validate it was okay to love it, because I wanted to make sure my gut feeling matched up with it being a “solid program”. After my meeting with him, I realized that I no longer cared about reviewing my rank list with the other 2-3 surgeons I had planned to. I would get a mix of perspectives that would have confused me more. I knew where my heart was, so I wasn’t going to keep confusing it by talking about my list more. Simply put, those mentors weren’t me. I decided to make my list without further input. (You’ll notice here my clear example of bias. I used his positive feedback to validate my choice on SLU, but I ignored his negative feedback about the program I eventually ranked #1. Turns out it was likely a good thing I didn’t match there. Ignoring the parts that disagreed with my worldview was an incredibly biased and un-scientific way of thinking. Do you want a distorted reality? Because that’s how you get a distorted reality)
What I’m saying here is not, “Don’t talk to anyone about your rank list or interview tips because they don’t matter”. What I’m saying is to be careful and feel out when to take advice and when not to. Trust your intestines (that’s so much more fun than saying gut) That leads into step 0:
Step 0: Know Thyself, And to Thyself be Mostly True
More accurately, the quote coming from Polonius in the play Hamlet is,
This above all: to thine own self be true
And it must follow, as the night the day
Thou canst not then be false to any man
While I hated reading that play (and let’s be real, I probably didn’t read it. I think I was even too lazy to use Sparknotes, and hence floundered my way through the class discussions), this quote has stuck with me. This is contrasted with a quote from one of my old roommates,
If you ever want anyone to like you, change everything about yourself, you’re a terrible person.
While he is a god of dark humor and witty insults and likely meant this somewhat sarcastically, there is truth in this statement. These contrasting views both apply to the interview process.
On one hand, you shouldn’t change yourself for your interviews, because if a program likes a you that isn’t…you, then you are starting the whole thing off on a false premise. On the other hand, if you’ve got bad parts about yourself…you should definitely change those, because they’re going to set you back (and violate Step 2 of this guide). It’s at this point I’ve realized this guide could also function as a dating guide considering what I have planned for the upcoming steps. Turns out they are remarkably similar.
Things you shouldn’t change: Your personality*, interests, likes, and dislikes. If you’re a social extrovert, be one during interviews! If you are on the quiet side and more introverted, be that! You don’t have to dominate conversations or tell the best stories during the night before dinner, or at any point throughout the interview day. The loudest wheel isn’t necessarily the best one. If you have things you are passionate about, let that passion show through. It doesn’t matter whether that is biking, martial arts, beekeeping, or competing in gingerbread house competitions. Residency programs want to see that you have things in life that you can talk about besides medicine. Your relationships with your future co-residents will be based as much on medicine as much as your mutual love of Dungeons and Dragons.
*Your basic personality traits should not change…as long as they are good qualities. If you’re nice, caring, etc., present yourself as you normally would. However, if you have personality flaws such as laziness, you best not present any whiff of them. In fact, you should deeply evaluate and treat those problems, rather than brush them under the rug for 4 months before they re-surface.
Things you should change: Your personality flaws, bad habits, poor taste in dress, or any “sharp edges” you have. Let’s be serious, at the very youngest you are in your mid twenties, which means that you better have learned how to evaluate yourself as a person. You best not take those flaws into interviews, and actively work on changing them. The main thing here is to soften any sharp points. Do you talk too much? Are you too loud? Back off and learn to shut up occasionally. I’ve seen people try to dominate conversations during the night before dinner. Do you often come in late to things or cut them too close on time (like I tend to do)? Do not show up late to anything during the interview process (this will appear again later).
You need to think about those things that you need to change or might be perceived as negative. The point is to not be on the extremes. There’s some military saying that says don’t be first or last. Don’t be too loud, don’t be too quiet, don’t be dressed too casual or too over-the-top. Fitting in is the name of the game sometimes. The extremes of personality traits often attract more negative than positive attention. Speaking of attraction…
Step 1: Be Attractive
This doesn’t necessarily mean to be physically attractive, but that won’t hurt. If you happen to be blessed with good genetics and have the audacity to go to the gym every now and again, that will 100% help your chances. There’s a bunch of studies about how attractive people have it better when it comes to getting jobs or whatever in life, and I’m not going to bore you with them here. This is no place for statistics. So, if you happen to be 2% body fat and a model, good on you. We’re not jealous or anything.
Oh, and be tall too if you can. Height is generally correlated with perceived leadership ability, income, and a lot of other things for whatever ridiculous reasons, and you can read some of the literature like this paper if you’d like, or Google “height and leadership”. Maybe it’s the physical “looking up” to someone, maybe it’s that height is seen as dominant, or maybe it’s Maybelline. Regardless, height helps you more if you’re male, but also if you’re female to a lesser degree.
I mention those two points because I have a very strong hunch they played a part in how I was perceived. You can check out my sexy residency mugshot in the “About” section of my blog, but I was once told I’m “not the ugliest person alive”. I’ll let you be the judge of that, bonus monkey bread and black and white filter for +1 to sexiness.
I also was born to tall parents and have been a basketball player and athlete most of my life. At 6’3″, 215 lbs (clocking in at nearly 230 after interview season…welp), I’m a large, athletic dude. When it comes to the world of surgery, which can be kind of like the military, looking like a stereotypical “leader” most likely helped with my initial impression.
However, being attractive means way more than physical traits. It means having a warm smile, being easy to talk to, appearing comfortable and confident, having good smelling breath, and being an interesting person. You want to maintain an air of professionalism, but if you can’t laugh at yourself in an interview or smile and be goofy, you might be in trouble. You want your interviewer to instantly like you. Now, there will be some people (or even entire programs) that you won’t mesh with, but as a whole your goal should be to make people want to be your colleague.
You want to be the type of resident any program wants. Universally, programs want residents that are hard working, self-motivated, reliable, and enjoyable to be around. If you can showcase those traits of yourself, do so! Put yourself in an interviewer’s shoes…think, “If I were a program director, what would I want in a resident?” That’s a simple exercise that is pretty enlightening. For surgery, I understood they desired residents that wouldn’t crack under pressure, would stay strong when the world is crashing around them, and willing to run through a wall if necessary. Additionally, they want residents that will be fun to work with while standing for 8 hours in one place. That point cannot be overstated, because in residency you have a 100% chance of spending more time with your co-residents and faculty than with your family.
The wants will differ across specialties and programs, but always keep them in mind. Interviewing at an academic program? They are going to want academic stars that will shine as both a resident and researcher. A community program? They want someone who will be involved in their program and community, maybe by virtue of outreach or otherwise. Community programs might also be looking for a resident interested in kick-starting research efforts to bring more prestige to their program, or in residents that will practice in that community after graduating. Interviewing at an inner city program with a high Hispanic population? If you’re fluent in Spanish, you 100% want to emphasize that. This brings me to Step 2…
Step 2: Don’t Be Unattractive
Steps 1 and 2 (taken from Rule #1 and #2 of Tinder or any form of dating in existence) go hand in hand. They are not equivalent. Step 2 is my way of saying if you have bad things about you, fix them or don’t let them show. You want the program and your interviewers to like you without disliking you. While you might have charmed them with your tales of treating underprivileged kids in mountain villages in Africa, all it takes is you saying you believe that women can’t be as good of surgeons as men to punch your ticket straight to the bottom of the rank list. Or worse, could earn you DNR status – “Do Not Rank”. That’s a real thing. Some candidates interview so terribly that the program would rather have an empty spot than match that person. That’s worse than Becky not giving you her number. That’s Becky saying she’d rather die alone if you were the last man on Earth.
The fastest way to do this, and every program has a story like this, is to be rude to the program coordinator. While nearly all candidates will be nice to their interviewers and program director, there is someone who thinks it is okay to be rude to the coordinator about some trivial matter. FYI, the program coordinator is what makes everything about the interview process (and a lot of your residency) run smoothly. They are one of the people you want to keep the happiest throughout your interview process.
So, always be cautious about how you come across to everyone you interact with. Make sure you are always pleasant, respectful, and courteous. However, if you’re the type of person that doesn’t implicitly understand that you should be nice to everyone you encounter, especially during interviews, you’re already lost.
If you are interviewing at a program that mandates 2 years of research, don’t talk about how much you hate research. In fact, why would you even apply to a place like that if you hated research? That would be a pretty unattractive thing to mention in your interview. Get where I’m going with this…?
You don’t want to be unattractive on paper either. While at this point you can’t change those things (short of making sure you didn’t make an stupid spelling or grammar mistakes on your ERAS application), do your best to not be unattractive in person. Which leads to the next step:
Step 3: Be Dressed Right
Oooooooh boy does this include a lot of things. You want to be a presentable human being. This involves the basics like showering before your interview and wearing deodorant. If you have an Anthony Davis style monobrow (or is it unibrow?), invest in a pair of tweezers for God’s sake. You do not make enough money playing professional basketball to rock that thing. Trim your fingernails (I saw guys with knives on their fingers. How do they think they’re going to fit those into surgical gloves?!), and make sure your clothes don’t have stains on them. Become friends with an ironing board. There are so many basic things that I saw huge fails at.
First, I’ll speak about the dinner the night before your interview. All programs have this as an opportunity to meet the residents (generally) without the faculty there. In most cases, they will tell you the dress code in an email before the event. However, most of them say “business casual” or some other vague term. I’m convinced nobody knows what business casual actually means. Regardless, here is what I wore to almost every one of these (except the ones that said jeans as the dress code).
This picture makes my shirt look like an optical illusion. I can assure you, it doesn’t hurt your eyes as much in real life.
As you can see, I wore a nice pair of slacks with a button down. I altered the details to match the occasion. If it was less formal, I rolled up my sleeves and didn’t wear a tie. If it was more formal, I put on a navy blue tie and buttoned my sleeves fully. I could even stuff the tie in my back pocket if I felt I wasn’t sure, so that I could quickly alter my dress to match nearly any situation. I never felt under or over-dressed with this outfit. I hear on the East coast that sometimes the dinner would be a sport coat or suit type of event, but I didn’t have any that formal. I had two that were specified as being jeans.
When it came to the actual interview, I wore a black suit with black belt, black shoes, white shirt, and varied the color of my tie in an attempt to match the program’s colors. I.e. I wore a green tie for Michigan state, black and gold for Mizzou, red for Indiana, etc. That was enough variation to help me be unique, but not enough to stand out. In general, gentlemen, wear a dark suit without a crazy pattern with a tie that matches in some way. I don’t know what defines clashing colors, but don’t let your colors clash. Always match your belt and shoes. I wore a silver tie bar as well as a dark watch. I purchased the watch specifically because my usual attire of big rubber G-Shocks weren’t quite formal enough. It was time I owned a nice watch anyway. I let my watch and tie bar be my personal accents. In line with my personality, I wasn’t trying to stand out with the way I dressed. Fitting in = good.
I saw a few guys who wore weird color suits like light gray or stripes, and I thought they were a little…much. I mean do what you will and express yourself, but the overwhelming consensus was to be conservative. Orange suits are a no go. Surgery in particular still has some of that “old guard” mentality that might be turned off by anything that deviates at all from the norm.
If you have hair, style it or something, I buzz mine because I don’t like dealing with it, so that made my choice easy. I also carried a nice leather padfolio for all of my interviews so I could keep all the papers I was given in one place. They give you a folder everywhere you go, but a padfolio looks classy. If I’m being real, I only had a padfolio because I was given it by IU as an undergrad, so it still fit for IU School of Medicine. I wouldn’t have gone out and bought my own padfolio, but I had it, so might as well use it.
My two cents as far as ladies dress is the same as for the guys: dress conservative and don’t stand out too much. Tasteful pink heels are fine, an entirely pink suit is probably not. Be mindful of your skirt length and necklines. Guys have no equivalent to these things, so I feel like our lives are much easier. Skirt suit versus pant suit already boggles my mind with the choices, let alone that you could wear one of a bazillion kinds of blouse. All our dress shirts are pretty much the same. We also (generally) don’t have to worry about modesty quite as much. I hung up my cut-off suit a long time ago, so there was no “sun’s out, guns out” type of temptation.
If any woman wants to enlighten me on general dress code for ladies, please write a paragraph or two and send it to me. I will give you credit as well as post it in this section. I’m a simple man and can mostly only provide male advice.
Step 4: Review Your Application
So you’ve already talked to your mentors (or not), gotten a nice new haircut, picked out a nice suit and something to wear the night before, and have fixed every issue with your personality. The next step is quite simple: preparation. This comes in two forms.
The first is you must know your application inside and out. Anything you have written on ERAS is fair game for interview questions. Review your personal statement, activities, and especially any research projects you have been involved in. You should be able to give a ~60 second summary of any research projects, as well as talk at length about anything on your application. This is a simple step that is easy to overlook if you haven’t done anything with that random research paper you were involved in 2 years ago, or if you haven’t looked at your personal statement in a month. When it comes to the actual interview…
Step 5: Prepare For Your Interview…or Not
This is the second form of preparation: preparing for the interview itself. There are two schools of thought on the matter: either prepare for every possible scenario, or hardly prepare at all and wing it. You don’t want to be caught in this awkward middle ground where you have half-baked answers that lack gusto. Now, this scope of preparation exists along a spectrum, but my two cents is that you want to tend to one side or the other. I was towards the “wing it” end.
What I’d recommend everyone do, and by that I mean make the opportunity to, is to sit down and do a mock interview. One of the best parts of my away rotation at the University of Maryland is they had a significant emphasis on residency application and interview preparation. We had a personal statement and application session, a recorded mock-interview, and a review of our interview video. Now unfortunately, my interview video didn’t actually record, but the feedback was valuable nonetheless. My interviewer was looking for things like verbal tics (such as saying “umm” or “like” frequently), motor tics such as foot tapping or changing position, and analyzing tone of voice, speech patterns, and the content of my answers. This is where I learned I said “mhm” a lot when my interviewer was talking (and consciously reduced the amount I said it during interview season and life in general), and that I otherwise was well composed. I’d recommend having a mentor or faculty member do this, but roommates and friends can work as well.
Another piece of advice is that everyone should minimize and ideally eliminate the use of vocal fillers such as “uhh’s” and “umm’s”. If you repeatedly use the word “like”, eliminate that as well. You need to spend a few days consciously analyzing your speech. These fillers, besides making people like me unable to concentrate on what you’re saying, murder your speech. Only the most trained speakers do not use fillers at all, but I guarantee you sound much more intelligent and confident without these fillers. While I’m not perfect at this, I’m at a very low level of filler, even in everyday conversation. When people get nervous, these fillers amplify. Making a habit of slowing yourself down and being aware of your speech in these mock interview situations will help.
While I’m a huge advocate for practicing speech patterns, mannerisms, and tone of voice, I swung far the other way when it came time for preparing for specific interview questions. You can search for “lists of residency interview questions” if you’d like and have canned answers for all of them. I’m very comfortable coming up with answers on the spot and love improvising, so I did not prepare answers to questions. That would have thrown off my groove. Now this led to 2-3 times where I had to think more than 5 seconds to come up with a good answer, but overall worked out well. I could come up with an example that fit the flow as well as what I perceived would best fit my interviewer. There’s no way for me to consciously explain how I did it, just that I thought it worked out. It’s like asking a freestyle rapper how they come up with words on the fly. If you’re that type of person too, good for you. If not, good for you too and you should prepare answers to the most common questions.
At the end of the day, remember that an interview is a conversation, and just because you’re all wearing suits and talking across a desk, it’s not that different from any other time you’ve spoken to another human being.
Again, remember my personal slant is coming through, as I’m a confident public speaker and have minimal amounts of interview anxiety. I’m fairly relaxed speaking to people and think of myself as a good interviewer (and have been told the same during mock interviews, so it’s at least not entirely me being conceited). I do, however, think everyone needs a healthy dose of chillllllllllllllll for interviews. You are auditioning to be a colleague with the person across from you, not some peon at the bottom of the food chain. At the end of 3-7 years, you will be on their level (excluding their years of experience as faculty).
Step 6: Understand the Types of Questions…and Those You Can’t Prepare For
You will get the same types of questions no matter how many interviews you go on. They are divided into a few basic categories that I came up with as I was writing this: questions about you as a person, questions about things in your application, questions about your aspirations, “Why our program?”, “What questions do you have for us?” (if I never hear that phrase again, it will be too soon), off-the-wall, and situations. The first few categories are fairly self explanatory. I’ll give you some common examples, the ones in bold you will see at every interview.
Examples of questions about you: Where are you from? Why did you choose medicine? Why did you choose this specialty? What do you do outside of medicine? Tell me about yourself? Tell me about your family? What are your greatest strengths/weaknesses? Describe yourself in 3 words? What was the last book you read/movie you saw? Do you know Dr. X/Y/Z from your program? You won’t always get the dreaded “Tell me about yourself?” question, thankfully. I received questions about martial arts from >90% of people who interviewed me, considering it was about medicine and martial arts. You can find my personal statement in Part 2.
Examples about your application: Tell me about activity X in your application/personal statement. What do you do for fun? Dr. X said this about you in your recommendation letter, why is that? Why did you not get honors in surgery? Tell me about your grades/which rotations you did well in? Tell me about your research in Y? Or about paper Z you listed here?
Examples about aspirations: Where do you see yourself in 10 years? (super common). Do you see yourself subspecializing? If so in what? What qualities do you bring to a residency program? What are things you will pride yourself on as a resident?
Examples about “Why our program?”: Why did you apply here? (I always found a way to relate my goal to their program. There was one main thing I wanted out of a program when it came to answering to this question: opportunity. I assumed that everywhere would generally have complex patients, good faculty, good technical training, great co-residents, etc. I think all of those things are boring answers barring the complex, sick patients one. What I ideally wanted was a program very similar to IU’s with multiple hospitals, a medical school, a VA, a private hospital, thriving city around it, etc., I managed to tailor my goal of “opportunity” to whichever program I was interviewing at, even if it didn’t have all those things. That’s a common theme for answering this question: tailor it, obviously.) What are the things you are looking for in a residency program? Where else have you applied/what region have you applied? (Technically this is a question they are NOT allowed to ask you. You will get asked anyway. I’m not sure if it’s out of ignorance or willful disregard, but you can find info on the NRMP Code of Conduct Page). What is important to you in a program? What can you bring to our program? Do you have any family/friends nearby in the area?
***WARNING: QUESTION YOU WILL GET ASKED ON EVERY INTERVIEW IS AHEAD***
“What questions do you have for us?”: On the list of factors that put someone at risk for suicide, being asked this question hundreds of times should be considered high risk. You will get asked this by every interviewer at every institution you go to. Period. It. S.U.C.K.S. Badly. I want to make the words sucks so large it takes up the entire page. Long story short is that you should ask something here to prove that you at least put some effort into it. You can ask about some specific thing that program does, “Tell me about your efforts in helping the residents get robotic surgery experience?“, about something you are interested in, “What are the other opportunities for bench research? Can I take time off for research even if it is not mandated? Am I able to get advanced degrees?”. Generally, try to make this something that wasn’t well-covered during the presentation about the program.
After those questions are exhausted, I used this as a way to have a little fun. When the residents asked this the night before, I would ask things about the gym or dating life in that city, things that I care about. But my favorite was, “What is the funniest thing that has happened to you this year?” Residents love this question, because it will spark off a chain of hilarious stories. Feel free to use it.
When it came to faculty, I would ask them how they got to the program or why they got there as a way to gauge how important faculty recruiting and retention is. I could also get a sense of if they were happy. Another things is I would ask them to use 1-3 words to describe what they wanted in a resident. My favorite answer: “Grit”. I’m stealing that answer when I’m faculty one day. Come up with fun, creative things. You can even ask what the faculty do when they aren’t working. This could be the time where you get into a 20 minute conversation about brewing homemade beer, and I guarantee they will remember more from that 20 minutes than 20 minutes yapping on about medicine.
***NOW RESUME REGULAR PROGRAMMING***
Examples of off-the-wall? If you were a superhero, who would you be? What’s your favorite ice cream and why? Walk me through how you make deep dish pizza? (A real question I got asked after I explained my love of cooking and one of my favorite dishes I make). Batman or Superman? Why? What is your favorite quote/life motto? Who is the best rock band of all time? (The temptation to say Nickelback was sooooo strong. I would’ve been kicked out of the room though).
***Situations***: These are the types of questions that are incredibly difficult to prepare for, sometimes bordering on impossible. However, they can also tell the most about an applicant. In fact, SLU switched to an all-situational approach to their interviews because they were tired of the traditional questions and felt situational questions were much more telling. These questions are about how you think. They are designed to isolate your thought process and force you to speak it aloud. Turns out I’m a pretty big fan of these types of questions.
There are two types. One will ask you about your real life experience and how you reacted to it. Common examples include: Tell me about a time you didn’t get along with someone in the healthcare field? How did that end? Tell me about a difficult time you had in medical school? Tell me about a time where you messed up on a rotation, and how did you fix that? What is the biggest challenge you have faced? Take one of your chief residents and tell me 3 of their best and worst qualities? Why do you see these qualities that way?
The second type deals with hypothetical situations. They will set you up with something like, “You are an intern on night float. A nurse disagrees with your orders and refuses to give the patient the treatment you know is correct. How do you resolve it?” or, “Your chief resident messes up during a case and doesn’t tell the faculty when they come into the room. The case ends, how do you deal with it, knowing this happened?”
It’s pretty clear these questions are…difficult. They are designed to put you on the spot in a way you can’t perfectly prepare for. I’m sure there’s some kind of research into if they’re somehow more effective, but I don’t care. In surgery, you will encounter these questions in >50% of interviews, and my guess is that we’ll see that percentage increasing over the years. I have a feeling that the age-old residency interview process will catch the “evidence-based” bug at some point, and I’m sure it will be for the better.
I developed my own strategy for the hypothetical situations. It’s not really a strategy, it’s more like this is what I would actually do in real life, but regardless it boils down to one thing: COMMUNICATION. Big surprise. It is as such:
Try to gather more information: “Why did you choose to do that chief? Why don’t you think that is the right treatment, nurse?
Explain my perspective: “That feels like the wrong thing to do, our staff needs to know because this is a patient care issue/Here’s why I believe this is the treatment required, providing evidence if necessary”
Contemplate if I’m in the wrong: Take a look at my actions and see if I’m doing the right thing. There is a chance my chief/the nurse knows better than me. If not, I proceed to the next step
Try to resolve conflict: “Let’s talk about this, see if we can come to an understanding/Why do you think we shouldn’t tell our staff?”. This step is often followed by some kind of refusal by the chief/nurse/whoever.
Ask for help: At the point where I’m stumped, I’m going to ask either an upper level resident, my chief, or my staff for help on the issue. I might even ask someone not involved with the situation if it’s not time sensitive. In medicine, we are very seldom alone. Asking for help is important.
Escalate the situation, if necessary: This means going past my upper level resident to talk to my staff if I think they are not handling the situation correctly/getting my upper level or the charge nurse involved with the nurse refusing the order. This is the last ditch step when all prior efforts have been met with a brick wall.
Remember, at the end of the day, it is ALWAYS about what is best for the patient. That’s the unifying theme in these scenarios. I shouldn’t have to come out and say that, because if you’re in medicine that should be at the core of your being, but I’m stating it for completeness sake. I’d say that statement out loud during my interview if I had to drive home the point. This is my general template for any conflict in the hospital or in life. It’s served me well thus far.
Step 7: Realize How Much of Your Application Your Interviewer has Read
Answer: Not a lot. Don’t be surprised and/or appalled by this. I interviewed at some programs where they did completely blind interviews, such that they only knew my name and medical school I came from. They then read my application after. It’s a cool concept, as they come in with no preconceived notions.
Regardless, most of them will have at a minimum read your personal statement, looked at your STEP scores, and maybe your hobbies section. Often, that is it (or at least seemed like that was it). Others will have perused your grades, maybe read a rotation comment or two in your chosen specialty (fairly uncommon), or even looked at your research or other activities.
My big point here is put important things in your personal statement. I wanted every single person interviewing me to know that I got two black belts while I was in medical school, and that I still actively train martial arts. Which leads into my next point:
Step 8: Understand How to Sell Yourself
That’s actually not a factually accurate step. Again, playing by my rules here. That should read “Understand How to Emphasize Your Desirable Qualities”. Selling yourself sounds…forced. But I think that’s a slightly more catchy title.
This goes back to getting in the mind of your interviewers and being “attractive” to them. What do they want in a resident?
Throughout my interviews, I wanted to walk away with my interviewer being sure of a few things about me:
- I am going to work hard because I am no stranger to hard work.
- I know what it’s like to work well in a team and handle adversity.
- I will not crack under pressure.
- I’m personable, easy to talk to, know how to have fun, and have a life and hobbies outside of medicine.
- I’m the guy who wants to handle data and do outcomes based research, and my math background is a testament that.
If I walked away sending that message, I knew I succeeded. I wanted to play up those qualities during the interview. Are you incredibly creative? Motivated? Tough? Able to undertake large challenges like planning a conference from the ground up? Make that known during your interview! I know my strengths and have experiences to back them up. That leads to the next step:
Step 9: Show, Don’t Tell
“I’m very hardworking, dependable, and a team player”
“I trained 4-5 days a week for 4 years to get black belts in two martial arts during medical school, was a resident assistant in college for two years where I was responsible for 55 male students, and have led and been a part of teams in basketball, fellow resident assistants, helped in martial arts demonstrations, and been a CS:GO in-game leader”
“I’m a very interesting person with a lot of interests, I like television, adventures, and sarcasm”
“Let me show you some pictures from this hiking trip I went on. Have you read ‘House of God’? Let me tell you about it. *actually tells a funny story about some thing*”
The contrast between those two sets of statement should slap you across the face like a wet sandwich (ew?). Again, this is another concept that is equally applicable to dating and interviewing (which at this point, I’ve convinced myself they are in fact the same thing). You want to have reasons and stories for the qualities about yourself. There is not a single person interviewing you who wants to hear the phrase, “I am x” where x = some quality about you. Show, don’t tell!
Think about the things you want your interviewers to remember about you, those qualities that make up the core of your being. Then, search for an example to show them why you are x. You want to tell them you are the type of person that will run through a wall if necessary without explicitly stating that. You will bore your interviewers to tears if you go on and on about, “I am x, I am y, I am zzzz……”
If you take a moment to wonder why this is the case, remember the whole evidence-based medicine shindig? Well, this is evidence based interviewing! Have proof that you will make a good resident! Now I’m hoping this isn’t the case, but if you are sitting there thinking, “OhmygodIdon’thaveproof“, please breathe for a second and remember that sentences need spaces. Slow yourself down and think. If you can’t think of any examples, pull a Who Wants to Be a Millionaire? and phone a friend. Ask your friends, family, mentors, dog, or local stray cat for help. I’m sure they can brainstorm and come up with ideas.
Alternatively, if you need a change of mindset, think of yourself trying to impress the man/woman of your dreams. What would they find attractive? What can you use as an example of qualities about yourself? Another side note here, the “show, don’t tell” concept is a target that is frequently whiffed when it comes to creating a dating profile online or dating in real life. The best way to be an interesting person is to do interesting things. That’ll be $50. Onward…
Step 10: Smile and Play Nice With Others
This is another one of the things that I shouldn’t have to say, but I’m saying it so it’s at the forefront of your mind. Smile, be nice, and have a good time, or…at least act like it. Interviewing can be fun if you make it that way! You want to be the person who is easygoing and gets along with the other applicants, not so much because it will help you, but because it will hurt you if the residents/interviewers/staff notice that you’re a lone wolf. At >99% of residency programs, you will have at least one other co-resident. If you can’t get along with the people you are interviewing with, that’s a pretty bad prognostic indicator.
That being said, despite the fact that there are certain personality types that flock to your chosen specialty, not everyone is the same. You will meet people where you think, “Wow, you are going into surgery?…Did I choose the wrong field if I’m going to be with people like this?” While I’d encourage you to swallow that feeling and discard it, you are going to think that at some point. That’s okay, that’s human. This gets more into the process of selecting a program (which I’ll get to in another post), but you will see that there is variation between personalities even among different programs in the same specialty. The residents at SLU were very different than the residents at Eastern Virginia, or Nebraska, or all of the other places I interviewed. You want to find the ones that fit you.
Even your fellow applicants will have a different flavor at different programs. What I’m saying is that whether you like them or not, get over yourself and be friendly. I loved the group of applicants to SLU (and even met one of my future co-residents as the first person I met on the interview trail. We were the first two people at the night-before dinner, and I thought he was a legit dude. There was a group of 4 of us that had a great time that night. Whattup, Matt!).
I mentioned the program coordinator earlier and how you should be extra nice to them, but you should also be nice to each and every single staff member during the interview day. Again, I shouldn’t have to say that, but this serves as the place I can point at and say, “Told you so” if you blow it at an interview because you were rude.
Step 11: Be Early
I’m about out of advice specific to the interview itself, but this is my last piece: Don’t be late. To anything. Ever.
Okay, now that my completely unrealistic piece of advice is out there, let’s be real about this: Your best laid plans will sometimes go to sh*t. With most people going on double digit interviews, traveling from one to the next, and sometimes packing them between days on rotations, something will inevitably go wrong. If your flight gets delayed/weather makes driving dangerous or shuts down the airport, you get caught in traffic, or whatever it is, call the program coordinator ASAP and let them know your situation. Nearly every place will work with you, and as long as you make it somewhere relatively on time and do everything you can, things will work out. However, if you no-show or don’t communicate, you screw yourself. Re-read that sentence. Your absence might even screw others, as our program director once told us there is a specific medical school they won’t ever offer interviews to because they had recurrent no-shows for interview days. Don’t be that person.
The night before dinner is something that is mostly a chill event and you can be a little late to. In the later parts of the interview season, I’d show up 20 minutes late occasionally because I didn’t start driving early enough or whatever the case was. I don’t condone that, but I still survived. I unfortunately have a chronic problem with cutting times too close; that is a work in progress. However, even for my less-than-punctual self, I was always early on the actual day of the interview, no exceptions. You should always be early too. Take that from the mouth (or fingers) of a guy who has problems being early.
Step 12: Travel (and Schedule) Smart
Okay, I’m officially out of interview-specific advice. I’m not going to tell you to take notes on places or have a meticulous checklist of things you need to take with you. You do you.
With regards to travel, all I’ll say is travel smart. Living in the center of Indiana, most places in the Midwest were within driving distance. My general rule was any place over 7 hours was going to be a flight. Book your tickets 4-6 weeks in advance for the best pricing using whatever tool you deem convenient (I used American Express Travel). If you want, search online for ways to save money on flights. A fellow interviewee when I was at Mizzou explained in detail how he opened a bunch of credit cards and used the points on each in some convoluted way to get all his flights for free. While I commend him on his methods, that wasn’t something I was interested in doing for multiple reasons. One being laziness and two being I didn’t want to open a bunch of new cards. That said, it probably could’ve saved me over $2,000.
Make sure your car maintenance is up to speed and that you have a SHTF kit in your car (with things like a blanket, food, water, flat tire kit, AAA membership if you want, etc). Use your GPS or plan out your drive ahead of time, taking traffic into account (and time zone changes, if necessary! I didn’t realize St. Louis was a hour behind Indiana until I arrived 1.5 hours early to the night before dinner. That’s one way to be early, by forgetting the Central Time Zone exists!).
As far as hotels go, I used Hotwire and used their Hot Rate Hotels (not an advertisement, just being straightforward) and booked most of my hotels the day of. I’ve found this saves a lot of money compared to traditional booking. Very rarely did I used the suggested hotel with a “special rate” by the residency program, as it was often waaay more expensive than finding my own hotel a few minutes away. The only exceptions to this was if there was no other close hotel (such as remote locations), or if the convenience was somehow worth it (see: airport shuttle and the hotel being on the medical campus in upstate NY, where ride-sharing programs like Uber don’t exist. Good thing I found that out after I got there). One of my classmates used Airbnb everywhere and found it cheaper than hotels. To me, having a room to myself along with an ironing board, personal shower, etc., was worth it for a hotel over Airbnb. Your preferences may vary. Oh, and iron your clothes beforehand.
You can either try and squeeze as many interviews back-to-back or spread them out, do as you see fit. I had a period where I had 9 interviews in 21 days, and a period of 3 in a month. Do whatever you see fit, just know that being on the road for an extended period of time will wear on you and probably make you gain weight. Some of the girls actually found their suits not fitting later in the season.
Step 13: Don’t Drink Too Much
Self-explanatory. The night-before dinners will often have some form of alcohol, usually beer and/or wine. Every program has stories of at least 1 person per year who gets drunk that night. Don’t be that person. I had a strict rule of no more than 3 beers on any given interview. I’ve seen that person happen right in front of my eyes (turns out having ice buckets full of beer was too tempting for some people).
Step 14: Have Fun!
That’s it! This process is stressful, expensive, long, and arduous. Do your best to enjoy it, because it can be fun! For people like me, it got me out of my geographic sphere (having lived in Indiana most of my life), meet people from other programs, and enjoy some good food and beer. I read a lot of books, wrote some for my blog, and enjoyed the time in transit as much as I could. I listened to podcasts on the drives, rocked out to music, and put more than 5,000 miles on my car. The process will fly by and be over before you know it. Regardless, at the end of the day, despite how fun going on 14 interviews was, there was nothing quite like collapsing when I got home after my last flight in from Rochester, NY. My couch never felt so good.
Please contact me with any questions regarding this post or about your specific position in life, I’ve got quite a bit of free time at the moment.
I have officially finished medical school! I graduate in less than two weeks and it’s a little surreal to say the least.
This week’s songs are Traveling Man by Mike Posner and Let Me Oh by e-dubble. Feel free to leave a comment or contact me with any questions. Any other graduating MS4’s who have general or specialty-specific interview advice, feel free to contribute it and I will add it to this post.