Interview Tips for Trainees From a Program Director

Disclaimer: This post was written before the COVID-19 pandemic. Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years.

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It was Malcolm Gladwell who proclaimed that practicing anything for more than 10,000 hours allows one to become an expert.  If that is true, then I am a self-proclaimed expert when it comes to reviewing applications and conducting interviews for those applying to graduate medical education programs (residency and fellowship).  In the thirteen years I have been on faculty, I have served on the recruitment committees for the GI fellowship program for 8 years and Internal Medicine for 10 years. I am going into my sixth recruitment reason in the role of the Program Director for the Internal Medicine Residency program at my institution, where I personally review approximately 3000 applications per season, and meet one-on-one with nearly 500 interviewees each year.  The far majority of applications are extremely well done, due to the meticulous work of the medical students who spend countless hours reviewing and re-reviewing their application for errors. Similarly, most interview experiences are incredibly positive, due to the underlying principle that most people can keep it together on an interview without much effort.

In recent days, medical students from around the world have launched their application into the Electronic Residency Application Service (ERAS).  And now they must play the waiting game. As if trainees are not already glued to their electronic devices, in the days ahead, it becomes an obsession…checking one’s email for the desired interview invite.  Then begins the scramble of arranging travel, securing a hotel room, determining how to get from point A to point B, reviewing the where and when of interview dinners, and finally, picking out the interview outfit.  There is a lot do to in the next month before interviews begin, so hopefully these tips will help avoid some pitfalls that others have fallen into! You never want to be the example of “what not do to.” Why are these important things to consider?  Because studies have shown that once you have been selected for an interview, the interview itself becomes one of the most important factors in determining your position on the rank list. So let’s get started…

Nearly all programs will have an interview dinner the night before the interview with the residents.  You should plan for these to be casual, and if they recommended casual clothes, they mean it. The dinners will be a time for you to ask the current residents the pros and cons of the program.  You should be comfortable asking whatever you are curious about and feel that you need to know in order to make an informed decision. This is truly the intention of these dinners. The residents do not feed back your questions to the program, so be yourself.  However, if an applicant spends the entire time complaining endlessly about their current medical school or other things, the residents may indeed feed this back to program leadership that you may not be a good “fit.” The dinners may serve alcohol with the meal. If that is the case, don’t hesitate to order one. They are not doing that as a test to see who takes a glass of wine and who does not.  Programs want you to relax and enjoy yourself. Just don’t overdue it. One glass is fine, two is acceptable, but beyond that, you may not be on your A-game early the next morning, and it may send a professionalism signal if you are guzzling away on beer #4. Take-home points:

• Be yourself at the interview dinner, and ask the questions you really want to know, but avoid negativity or throwing your medical school under the bus.

• Drink responsibly, and get to bed at a decent hour after any interview dinner.

On the interview day itself, plan to arrive ~15 minutes before the start time of the interview day.  While being there a few minutes before that is fine, coming too early may lead to awkwardness if the program is still setting up the room for the day.  Even worse, however, is showing up late. Programs run interview days on a tight schedule, and an applicant who arrives late may hold up everyone from getting to morning report or other activities.  Give yourself PLENTY of time to check out of the hotel in the morning, and build in time for delays. It may vary who will be the one to greet you first thing in the morning…the education program coordinators (EPCs), the chief medical residents or the program director.  It should not matter who it is, as you should give each of them the same respect. I have seen applicants talk down to the EPCs, not realizing anyone was watching. That sends a huge signal, and one that is not forgotten. This would also include any communication you have with the residency program before or after the interview day itself.  I have heard countless stories from our EPCs over the years about the trainee who called to argue a point, or had to call a dozen times to verify the same thing, or needed their mother to call and arrange the interview for their child (with none of these things being normal). As the program director, I am there every morning at the start of the interview day, and I stand at the frame of the door to the conference room to welcome each candidate after they have checked in.  More than 98% stop to introduce themselves. The other 2% fly right past, like they are: 1) unaware of the obvious, like someone standing in the doorway to greet them; or 2) unfamiliar with the identity of the program director, which shows they may not have researched the program. Both are unusual. So the things to remember:

• Arrive in plenty of time before the start of the interview day, building in time for unexpected delays (hotel check out, transportation).

• Treat everyone you interact with through the interview season with respect. How an applicant treats the EPCs is often a sign of how they will treat other allied staff as a resident.  

Throughout the interview day, among tours, program overviews and other educational conferences, there are things that applicants do that may make them stand out…in a not-so-good kind of way.  First, let’s talk about the need to be well rested. Falling asleep during the interview day is an issue. We all get it…the room may be dimly lit, the overview talk may go on for some time, and the travel across time zones is really challenging.  Everyone may nod off at some point, so don’t beat yourself up if that happens. It has happened to the best of us. It is the full-on nap that is the problem. There is nothing that catches a program director’s eye more than when an applicant has a positive “O” sign, with mouth gaping open, tongue starting to dry, and deep in a dream-producing zone of sleep.  Do whatever you need to do to avoid this. Get decent sleep when you can. Timed caffeine intake may be critical. Ask your neighbor sitting next to you to nudge you if they see you nodding off. The second problematic issue is when there is an applicant who does not interact with anyone else throughout the day. They may sit alone in the conference room. They may be diligently reviewing their interview day folder to avoid eye contact with anyone. They may lag behind the group during the tour.  What message does this send? It shows that this person does not feel comfortable with group interaction. Unfortunately for those individuals, medicine is a team sport. If they don’t feel comfortable in this situation, it raises concern about how well they will function on a team, and how they may interact with patients. Don’t get me wrong…nervousness is ubiquitous on interview day, but social isolation is a flag. Finally, there may be the rare individual who has mysteriously made it to this point in their training despite missing part of their frontal lobe.  The person who makes inappropriate jokes. The person who makes fun of another candidate. The person who makes disparaging comments about patients. I have seen it all. Program directors all know that professionalism is the hardest competency to remediate, so they will not take the chance on such a trainee. Summary thoughts here include:

• Get plenty of rest the night before an interview, and take measures to assure you are alert and attentive on interview day.

• Don’t be the lone wolf on interview day.  A lone wolf may not interact well among a medical team.

• Keep your frontal lobe intact.  Any inappropriate behavior may prevent you from being considered by the program at all.  

The addiction to electronic devices has added more ways in which things may go south on interview day.  If an applicant is diligently texting or looking at their phone during tours or program interviews, that sends a message of disinterest.  Yes, there will be some down time when applicants are waiting for an interviewer to come and get them from the lobby, and if that is the case, it is fine to get out one’s device as needed (after all, maybe another interview invite came through!).  People often think that turning off their ringer is enough on an interview day. But is it? I would argue “no”. There is nothing worse when meeting one-on-one with an applicant, only to hear their phone starting to vibrate in their bag. Whoever is talking at that moment, whether it is the applicant or the interviewer, gets thrown off.  It makes them pause, reflect on what is making the noise, and causes them to lose concentration entirely. What is the best advice for this? POWER OFF during your one-on-one interviews. The same would be true for any watches that transmit text messages, which can be a huge distraction if someone’s watch is buzzing. Turn off that feature.  The following tips must be remembered:

• Don’t be checking your phone or texting throughout the day, as it displays a sense of disinterest.

• Take notes with pen and paper.  People will assume you are texting if you are taking notes with a device.

• Turn off the ringer throughout the day, but take the extra step to power off entirely during your one-on-one interviews.  

It is hard to give advice about what to say or do in the interview itself, as this will be unique to each applicant.  But there are some important things to consider. First and foremost, be yourself, and don’t try to be someone that you are not.  The more natural you are, the more genuine you will come across. Know your application very well. It always looks bad when someone asks an applicant about a hobby or activity they have listed on their application, and what comes back is a deer-in-the-headlights type of look.  It will make your interviewer question everything else. No one is perfect, and everyone has made mistakes or performed below personal expectation at some point, but that is ok. If an interviewer asks to share a mistake and what lesson was learned, this is a way to demonstrate insight into how you can prevent such things in the future. What did you learn?  That is more important than being perfect. Showing enthusiasm goes a long way. Most people never have this issue, as they are truly excited at the opportunity to interview, but the few that look like they are just punching the clock to get through the day negatively stand out. Use your travel time to start to think about things you will easily be able to talk about: your strengths and opportunities for growth, your past activities and hobbies, your patients that had a lasting impact, etc. Finally, when leaving the room with your interviewer, give a firm handshake.  There is nothing worse than the sweaty, limp-noodle sort of handshake. So, to make it a good interview:

• Be genuine, and that will allow the program to know the real you.

• Don’t be afraid of talking about your mistakes, as the insight demonstrated from those stories can show your maturity.

• Make sure you have a handshake that displays confidence.  

There are wardrobe tips and tricks that are essential.  The most important considerations in choosing your outfit are comfort and professionalism.  Make sure you can bend, walk, and sit without any issues. This seems like Wardrobe 101, but people have failed on this simple principle many times.  How so? There have been skirts that are so short that no one dares to look at that applicant once sitting, for fear the skirt is riding up ridiculously high.  There have been blouses with plunging necklines that reveal too much when bending over for a pen that was dropped. And there have been heels that are so high and rigid that the person walks with an antalgic gait.  This is the time to buy a nice suit or dress, and don’t worry about wearing the same one to each interview (although consider dry cleaning at natural breaks during your interview season to remove the stale smell that settles in).  Most interviewees pick an outfit that matches the grayscale-equivalent of printing. Don’t be afraid of color! While most people will choose a neutral-colored suit (although not required), don’t be afraid to pair it with a brightly colored blouse or shirt. I can still remember the applicants from each season who were not afraid of adding color (green, orange, fuchsia), as it set them apart from the seas of dark suits/dresses.  You should also invest in comfortable shoes. This does not translate into wearing shoes that your grandmother might wear, but if you elect to wear heels, make sure they are at a reasonable height that is comfortable when (not if) you walk a considerable distance. Be sure to wear them around before your first interview day to break them in and assess if you can tolerate them for a full day. A few suggestions to take into consideration:   

• Don’t be afraid to add a pop of color or design to your interview day outfit. It will make you stand out in a positive way!

• Wear comfortable shoes. And bring bandages in case you blister (but breaking them in first will avoid this).

• Bring a small repair kit that contains a needle and thread, safety pins, extra buttons, fabric tape and a Tide pen.  These things will come in handy if you have an unexpected “oops” on interview day.

Anything else you should bring with you on your interview tour besides a portfolio that contains a pen and paper?  Consider things like breath mints, a compact mirror and an extra pair of hosiery (if you elect to wear them). For your suitcase, consider packing a lint roller and either a portable steamer or a spray-on wrinkle releaser. And most importantly, don’t forget your smile and a positive attitude!