Many students who begin the process assume that admission to medical school is the final step on a long but rewarding journey. Unfortunately for the average medical students, they are only partially correct. Admission to and completion of medical school, while a laudable achievement, is only one more step completed in the marathon that is medical education. At the end of medical school, the process starts anew as the residency match. As with the medical school application, prospective residents will complete an electronic application to all the potential residencies they hope to attend; then the real work starts. Following the submission of the application, residency interviews will begin to arrive in the fall of the application year. The applicant will accept a number of these interviews that are often across the country from one another, even though they may occur during the same week. The process is daunting and can be confusing because it has to the tendency to feel much more serious than the medical admissions circuit. So what can the prospective resident do to prepare themselves for success and set themselves apart from other hopeful applicants?
While this heading may sound corny to the clerkship weary fourth year medical students who are reading this article frantically on the plane ride to their first residency interview, this may be the most important section of this article. First and foremost, being familiar not only with the content of your application but how it is likely to be perceived by the interviewer is critical. Understanding and owning the reality of your entire application (any poor grades, letters of recommendation, or areas of less-than-stellar performance) is fundamental. It is amazing the number of applicants to residency programs who simply ignore their potential weaknesses. As a resident and eventually an independent physician, knowing your own strengths and weaknesses is critical, and because of this, interviewers will expect you to be familiar with your own weaknesses. If you performed poorly in a pre-clinical class or rotation, you should expect to be asked about it at most of the interviews you attend. Plan ahead and consider a response that allows you to accept responsibility and explain how you addressed the poor performance.
In addition to knowing the reality of your application, knowing how your application is likely to be perceived by the interviewer is critically important. If you are applying to residency in neurological surgery and have medical school publications investigating the cutting-edge applications of laparoscopy for hysterectomy, many of the interviewers you speak with will likely ask you about these experiences. This is not to say that everyone who applies to a chosen specialty has to have known from birth what they wanted to do; however, you should be ready to explain aspects of your application that may not seem to align with the path you are currently pursuing.
Know the Specialty
All residency interviews are likely to share certain key interview topics and questions: “Tell me about yourself.” “Why did you choose medicine?” “Why did you choose X specialty?” or “Tell me about your greatest weakness.” However, aside from a portion of shared questions that are asked regardless of specialty, the rest of the interviews can vary widely with specialty. Interviews in highly competitive subspecialties such as radiation oncology, otolaryngology, or neurosurgery are likely to focus on aspects of your application that are important to them, such as your research experiences. Having a thorough understanding of any of the research projects mentioned on your application is crucial if you are applying to one of these specialties, as the interviewers are likely to take significant interest in your research experience and expect you to be articulate and able to describe your specific contributions.
In contrast, interviews for traditionally less competitive specialties such as family medicine, psychiatry, or physical medicine & rehabilitation are much less likely to focus heavily on your research background. Instead, interviews for these specialties tend to focus on the basic questions described previously as well as more holistically focused follow-up questions, when compared to the previously mentioned sub-specialties.
Additionally, if you are applying to a smaller sub-specialty in which sub-internships are an expected part of the application (neurosurgery or otolaryngology come to mind), be prepared to discuss why you picked the specific sub-internship locations that you did. In addition, be prepared to describe what you did and did not like about specific sub-internship experiences, WITHOUT bad-mouthing the respective programs. Saying the program “wasn’t the right fit” for you (while being vague) will come across much better to an interviewer than an MS4 sitting in a residency interview talking about how a specific residency program “wasn’t good” or “didn’t have enough operative volume for me.”
Know the Program
The residency application process is an attempt at creating a match – an applicant whose goals and personality traits mesh well with their respective program’s. Prior to each residency interview, you should carefully review the program and learn what features the program itself is proud of. Visiting the residency program website and understanding what aspects of the program are highlighted to potential applicants will give you a good idea of the aspects of the program the faculty view as unique. Using these as talking points is a good starting point when considering what you answer to the dreaded “So why this program?” question. You should be prepared to answer this question at every interview you go to, no matter the specialty, as it will come up (and likely you will be asked multiple times by different interviewers during the same interview day).
The residency interview process can be a very stressful time in an aspiring physician’s career. While you don’t want to over rehearse your answers so that they sound planned, a careful, honest review of your application prior to the interview season is the most important first step. Anticipating potential questions and thinking of how you will address concerns about blemishes on your application will prepare you for the interview. Consider the specialty to which you are applying, what aspects of the application are most important to that specialty, and be prepared to discuss those in detail during your interview. Above all else, be authentic. Think carefully about why, after all the time you’ve put in to get to this point, you want to continue your medical training at the institution at which you will be interviewing, and let the interviewers know why you genuinely think you would be a great fit for their program.