How Do I Prepare For Residency Interviews?

Jesse A. Cole, MD, Neuroradiologist, AOA graduate and author of “Getting Into Medical School Today”

While your USMLE® Step 1, USMLE® Step 2 CK, COMLEX® Step 1, COMLEX® Step 2 grades, personal statement, and letters of recommendation may help you obtain interviews for a residency position, your interview will most likely determine your ultimate fate. A great interview will get you ranked highly. A poor interview could torpedo your chances of even being considered. Like every else you have done to get into medical school and then complete medical school training, completing a great interview requires practice. Preparing for residency interviews should encompass your entire medical school career. 

Dale Carnegie, perhaps one of the most recognized early leaders in human interaction, stated there are six ways to make people like you.

1. Become genuinely interested in other people.
2. Smile.
3. Remember that a person’s name is to that person the sweetest and most important sound in any language.
4. Be a good listener; encourage others to talk about themselves.
5. Talk in terms of the other person’s interests.
6. Make the other person feel important -- and do it sincerely.

Good interviewing skills are not innate, and they require experience and practice. Like learning to take a history and physical, good interviewing skills for residency must be learned. While in medical school, look for rotations that will require you to improve your interviewing skills; while doing so, you will improve your ability to be interviewed. When interviewing patients, think about how you would respond. 

Study your patient’s body language and learn to control your own. Try to make each patient interview an opportunity for you to improve on your interviewing skills while improving your ability to be interviewed. Many schools offer a short class dedicated to interviewing skills, be sure to take it if available. If not, consider joining a Toastmasters® as it will force you to practice public speaking and give short two-minute extemporaneous speeches on a variety of subjects, very similar to what will occur in a residency program interview.

Prepare for residency program interviews by taking every opportunity you can to be interviewed. If you can find the time, apply for a part-time job or volunteer position. Most will require an interview. The experience you gain is worth the time and effort required, even if you eventually decline the position you are offered.

Before your residency interviews, arrange several practice interviews with a close friend, senior medical student, family member, personal physician, or family lawyer that usually does a lot of interviewing. If possible, record and review the interviews. Evaluate your performance. Are you maintaining interest? Listening to the question? Smiling? Sitting up and displaying good body language? 

Once you have completed several practice sessions, request one of your attendings to do a mock interview. They may uncover mannerisms that will detract from your interview performance. The assistance and critique from several skilled interviewers will enhance your residency interviewing skills and improve your ability to portray yourself positively.

It is important to help prepare your interviewer. Provide a list of questions, but tell the interviewers that any question they want to ask is fair game. The scope of residency interview questions is broad; answering “off the wall” questions will go a long way in preparing you for the unexpected question you may get. Popular question categories include reasons for picking the specialty, how you have prepared for the specialty, setbacks in your training, and extracurricular activities. A favorite open-ended question is “Tell me about yourself.”

Most interviewers are not concerned that most with your responses; they are more concerned with your ability to communicate in an organized and logical manner; in the back of their mind they are trying to determine if “this resident be a positive communicator with fellow residents, faculty, and patients.” Are you friendly? Do you listen carefully to the question? Can you defend yourself in a positive manner when asking about a setback in your career? Do you believe what you are saying? Are you confident? Can you respond in an organized manner quickly? Are you nervous? 

These are skills and qualities the interviewer is assessing. By preparing ahead of time, you will garner the ability and insight to appear calm and relaxed and state your opinion with confidence. Answering practice questions allow you to develop these abilities.

Interviewers may ask a large variety of questions. The following is a list of some of the more commonly asked questions. Practice your responses, but also practice answering questions on topics with which you have limited familiarity. You must acquire the ability to adapt to the questions quickly and formulate and provide a brief answer in an organized and logical manner.

Sample Questions

• Tell me about yourself.
• Where did you grow up?
• When did you decide you want to become an X?
• Do you think you will end up in private practice or academics?
• Where do you think you will want to live after your training?
• What are your hobbies?
• What sports do you play?
• What do you do in your free time?
• How have you prepared for this residency?
• If you had to change anything about your medical school education, what would you change?
• What are your greatest strengths?
• What is your biggest weakness?
• How do you handle stress?
• How do you handle depression?
• What is your single most exciting event in your life to date?
• What has been your biggest challenge in life?
• What is your biggest failure, and how did you handle it?
• What is the most difficult decision you have ever made?
• Have you ever watched anyone die?
• Why do you want to become an X?
• Why should I select you?
• What research have you done?
• Why did you get a “C” in rotation X?
• What leadership roles have you assumed?
• What was your favorite class in medical school?
• What was your favorite rotation in medical school?
• What do you do for fun?
• If you don’t match in X, what alternative specialty have you considered?
• What is your greatest fear regarding residency training?
• Where do you see yourself in ten years?
• How do you feel about taking care of indigent patients?
• What is your most embarrassing moment?
• What is the most stressful situation you have ever been in?
• What other residency interviews have you had?
• What do you think about the community?
• A patient has been waiting over an hour to see you and is very upset. What would you say to calm the patient down?
• What is your favorite sport?
• What do you believe will be your most important contribution to medicine?

Be prepared for questions that are posed to catch you off guard or for “shock value.” Applicants may be asked very odd questions such as “Tell me your favorite joke” or “What other career choice have you considered?” Hopefully, the interviewer will avoid intimate personal questions that will embarrass you.

As a resident, you will often find yourself asking patients intimate questions, and you must be comfortable doing so. Similarly, in answering personal interview questions, your responses need to be articulated without shyness or reserve. 

One question you should be prepared to address is, “Do you have any questions?” Be prepared! You should have multiple intelligent and thoughtful questions about the residency, the training, the hospital, and the community. You might consider asking special interest questions such as “Do you have any affiliation with foreign countries for international electives?” or “What research opportunities are available for residents?”.

If you are confident, one approach is to turn the tables on the interviewer and ask, “I am considering several training programs; why should I pick your training program over Mayo Clinic?”. Avoid asking any questions that may make you appear slothful or lazy, such as “How many night shifts will I do a month?”, “How much vacation time do I get?” or “How many hours will I expect to work a week?”

Expect a variety of interviewing styles, including combative, passive, agreeable, and soothing. Whether these tactics are deliberately undertaken or consistent with the interviewer’s personality is irrelevant. The important thing to remember is to stay calm; they may simply be testing your mettle, remain calm, and control your emotions whatever the interviewer's style. Remember: Do not overreact to what you cannot control.

One common mistake potential residents make is the failure to familiarize themselves with their curriculum vitae. Review all the classes you have taken, rotations you have completed, research papers you have written, and the literature you sourced, as well as any other activities you have mentioned. Do not assume you will remember the details of research or events that happened several years ago. If your resume notes something hard to explain, like a long leave of absence, have a  well-planned and logical explanation ready.

Whether the interview is live or electronic, dress appropriately. Be well-groomed, neatly trimmed hair, manicured fingernails, and cover-up tattoos. Men should wear a conservative suit and dress tie. Now is not the time to break out the Mickey Mouse tie your girlfriend bought you at Disneyland. The new sports jacket for a night out on the town should be left in the closet. 

Women should wear a conservative suit or dress. Avoid flashy revealing clothes and excessive makeup. Any dress styles that deviate from the norm should be avoided.

Save the “real you” for your next Friday night on the town; this is not the time or place to be overly noticeable. 

Have a nervous tick? Facial expressions that give away anxiety? Be on your guard and learn to control these behaviors and emotions. Watch out for overt signs of disinterest or nervousness. Sit up. Practice speaking in a forceful voice to project confidence. A favorite interview tactic is to place objects within your grasp, such as a paperclip or pens. Do not pick them up. Hands should be in your lap. Avoid crossing your arms as this projects disinterest. Multiple books are available on subliminal signs and gestures you should learn to control or avoid.

Some interviewers are downright nasty or mischievous. They may challenge you with false information to test your reaction. For example, you may be asked, “Why are your letters of recommendation so negative?” Such tactics, while uncommon, may catch you off guard. Your answer should be controlled and concise. Ask them politely to explain and then provide a controlled and well-mannered response without chastising the person you chose to write the letter to. 

Do not be surprised at an extremely odd interview. Applicants often report that the interviewer spent the entire time looking out the window. It is not fair, but it happens. Also, be aware of the “unknown” interviewer. Some programs may ask the secretary or tour guide to complete an evaluation.

After completing your interview, take a moment to write down the names and emails of your interviewers if available. Note the subjects you discussed and the points covered. When you get home, write a thank you letter or email. You should mention some of the key points the interviewer raised, what you enjoyed about the program, and thank the interviewer for their time. As the rank day approaches, if you interviewed very early, consider a follow-up letter reconfirming your interest to the interviewer and copy the program director a few weeks before the candidate selection deadline. 

Carefully edit any letter you send; there are countless horror stories about poorly written thank you letters that get circulated throughout the department for a good laugh. Don’t let this be your letter destroying your chances of success!

The residency interview is the culmination of years of efforts to complete medical school and eventually become a successful physician. For most training programs, it is one of the single most important aspects of their evaluation of candidates. If you have prepared for this day throughout medical school, you will present yourself well. Remember: The prepared applicant will present him- or herself in the best possible light.